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Pregnant women with primary or secondary syphilis who are allergic to penicillin should be desensitized and treated with penicillin g It is a reaction to treatment and not an allergic reaction to penicillin. Skin testing or oral graded penicillin dose challenge might be helpful in identifying women at risk for acute allergic reactions (see management of persons who have a history of penicillin allergy

26 year old man presents with rash, known contact to syphilis, new tinnitus Azithromycin has been studied as a potential alternative to penicillin for the treatment of early syphilis, with some studies suggesting similar efficacy. How would you proceed with treatment?

Of 12 patients identified, 83.3% were male and the median age was 39.

Abstract background gestational syphilis is underdiagnosed and undertreated, leading to stillbirth, prematurity, low birthweight, neonatal death, and congenital syphilis Most patients who label as allergic to penicillin are misdiagnosed Treatment options for syphilis in penicillin allergy the primary treatment for syphilis is penicillin g, but in cases of penicillin allergy, alternative treatments must be considered 3, 4, 5

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