(2,4) However, screening with RPR may not detect all cases of syphilis as non-treponemal tests lack sensitivity in few stages of syphilis like early primary syphilis and late latent syphilis
. A false negative result may also be due to the prozone phenomenon.
The recommendations for treating late latent syphilis
or latent syphilis of unknown duration is Benzathine penicillin G 7.2 million units administered as three doses of 2.4 million units IM weekly for three weeks.
Treatment should be given according to the clinical stage of the infection and, when this remains undefined or if no information is available about an expectant mother's adequate prior treatment, this should be considered as tertiary or late latent syphilis
Qui, "Osteomyelitis as the only manifestation of late latent syphilis
; case report and literature review," International Journal of STD and AIDS, vol.
Patients who have been treated for late latent syphilis
showed a low serological response with a persistence of the titers in more than 50 of cases after 5 years .
Rancane, "Screening assays to find out late latent syphilis
cases-which is the best one?," Internet Journal of Medical Update--E-journal, vol.
All patients who tested positive for syphilis were immediately sent to the reference center in order to be evaluated by a clinician for treatment with benzathine penicillin G 2.4 million units IM in a single dose (early latent syphilis) or benzathine penicillin G 7.2 million units total, administered as three doses of 2.4 million units IM each at one-week intervals (late latent syphilis
or latent syphilis of unknown duration) based on Colombian guidelines.
([paragraph]) For mothers with primary, secondary, or early latent syphilis, a single intramuscular dose of 2.4 million units of benzathine penicillin G; for mothers with late latent syphilis
, 7.2 million units of benzathine penicillin G, administered as 3 intramuscular doses of 2.4 million units each at one-week intervals.
Acute syphilitic posterior placoid chorioretinitis in late latent syphilis
. Int J STD AIDS.
Non-treponemal antibody titres peak during secondary syphilis and gradually decline; therefore, up to 20-25% of untreated late latent syphilis
may be undetected by a non-treponemal antibody test.
* Late latent syphilis
(including syphilis of unknown duration)
Given the nebulous history of exposure, we treated the patient as having late latent syphilis
(rather than secondary syphilis) and administered 2.4 million units benzathine penicillin G IM weekly for 3 weeks.