From the Guidelines
Early latent syphilis is a stage of syphilis infection that occurs within one year of initial infection but after the primary and secondary stages have passed, characterized by seroreactivity without other evidence of disease, as defined by the Centers for Disease Control and Prevention in 2002 1.
Definition and Diagnosis
Early latent syphilis can be diagnosed if, within the year preceding the evaluation, a patient had a documented seroconversion, unequivocal symptoms of primary or secondary syphilis, or a sex partner documented to have primary, secondary, or early latent syphilis 1.
- Patients with latent syphilis and who acquired syphilis within the preceding year are classified as having early latent syphilis.
- Nontreponemal serologic titers usually are higher during early latent syphilis than late latent syphilis, but early latent syphilis cannot be reliably distinguished from late latent syphilis solely on the basis of nontreponemal titers 1.
Treatment and Management
The recommended treatment for early latent syphilis is a single intramuscular injection of Benzathine penicillin G at a dose of 2.4 million units, as stated in the 2002 guidelines for treatment of sexually transmitted diseases 1.
- For patients with penicillin allergy, alternatives include doxycycline 100 mg orally twice daily for 14 days or tetracycline 500 mg orally four times daily for 14 days, but the effectiveness of these alternatives has not been well documented, especially in HIV-infected persons 1.
- HIV-infected patients who have early latent syphilis should be managed and treated according to the recommendations for HIV-negative patients who have primary and secondary syphilis 1.
Follow-up and Prevention
Regular follow-up testing is essential to ensure the infection has been successfully treated, typically at 6 and 12 months after treatment.
- Sexual partners from the past year should be notified, tested, and treated if necessary to prevent reinfection and further transmission.
- Early latent syphilis is considered highly infectious, and proper treatment at this stage can prevent progression to late syphilis, which can cause serious complications affecting the heart, brain, and other organs.
From the Research
Definition of Early Latent Syphilis
- Early latent syphilis is defined as a stage of syphilis that occurs after the secondary stage, characterized by a variable asymptomatic latent period 2.
- This stage is divided into early (<1 year) and late (>1 year) stages, with the early stages being potentially infectious 2.
Characteristics of Early Latent Syphilis
- Early latent syphilis is a period where the individual is infected with syphilis but does not exhibit any symptoms 2.
- During this stage, the individual can still transmit the disease to others 2.
- The early latent stage is typically followed by a late latent stage, which can last for many years 2.
Treatment of Early Latent Syphilis
- The treatment of early latent syphilis typically involves the use of penicillin G benzathine, which is the drug of choice for all stages of syphilis 3, 4.
- Alternative treatments, such as doxycycline, may be used in cases where penicillin cannot be used 4.
- Azithromycin has been shown to be effective in treating early syphilis, but its use is limited due to the emergence of resistance 5, 6.