The only other disease more feared by mankind over the ages than the plague, syphilis, the most serious of all the sexually transmitted diseases, is still thriving in promiscuous circles. Following is a concise, in-depth look into the puzzling stage of tertiary syphilis. Unlike most diseases, as syphilis progresses into the later stages, the treatment options become almost non-existent.
Too Many Are Diagnosed Too Late
Since 80 percent of syphilitic patients are not seen by doctors until they are well into this late or latent stage, to properly treat this third stage of syphilis, there must be an early diagnosis and treatment of the earlier stages. In addition, there must be a thorough understanding of the clinical manifestations.
Treatment of early syphilis begins with injections of antibiotics, such as benzathine penicillin G, in an intramuscular dose of 2.4 million units. This preferred form of penicillin is used because it maintains adequate blood levels for up to three weeks. This is followed by medication taken at home of other forms of penicillin, such as erythromycin or other antibiotics, such as tetracyclines, for a more aggressive course of treatment of 2,000 mg daily for up to two weeks.
Unlike Other Diseases that Get Worse in Later Stages
It is ironic that contrary to the way that "normal" diseases progress with the need for stronger and more drastic treatments later on, the later stages of syphilis, in its "latent" phase usually require no medications at all--at least no antisyphilitic meds. The reason for this is that the T. pallidum bacteria that remain in the body after the infectious stage has passed is not to any great degree susceptible to antimicrobial therapy. Conversely, many patients at this stage, if not sadly neglected-- are grossly over-treated.
If antibiotic treatment is continued, it is to prevent re-infection of the disease and internal syphilitic complications. Thus late or latent syphilis is usually treated with the same regimen as that used for aortic syphilis or neurosyphilis, syphilis of the spinal cord. An initial dose of 1,200,000 units, followed by eight doses of 600,000 each over a three week period is the norm.
With Proper Treatment the Odds Are in Your Favor
As far as the prognosis of third stage or latent syphilitic patients, since they exhibit no signs of infection, they will show no clinical evidence as a result of a successful course of therapy. The only way to determine the validity of the treatment or if the attainment of a natural immunity took place, would be to follow the course of the patient throughout his entire lifetime.
A reasonable prediction would be that less than 2 percent of patients with late latent syphilis who have been properly treated will develop any serious manifestations of late syphilis. The few who do show evidence of progression despite "adequate" treatment will be almost exclusively in the older age groups who may have had unrecognizable aortic syphilis at the time of treatment.
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