181.4 📌 章末速蚘

  • The Great Imitator: 1° chancre → 2° rash palms/soles + condyloma lata → latent → 3° gummas/CV/neuro
  • Neurosyphilis any stage: meningitis, meningovascular, tabes, paresis, ocular/otic
  • Treatment: Benzathine PCN G IM (1°/2°/early × 1; late × 3 weekly); Aqueous PCN G IV × 10-14d for neuro/ocular/otic
  • Pregnancy: PCN only (desensitize if allergic)
  • Doxy alt non-preg non-neuro
  • Jarisch-Herxheimer in 50% 1°/2° — supportive
  • Serology: NTT titer for activity, TT lifelong +
  • 2024 resurgence + congenital surge — surveillance + Doxy-PEP MSM
  • Argyll-Robertson pupil = tabes dorsalis classic