With the decrease of reported syphilis in the United States, and with this decrease being most marked in the early syphilis category, the proportion of latent syphilis to all syphilis has increased, since it is a chronic form of the disease. The necessity of differentiating the patient with latent syphilis from the BFP reactor becomes increasingly important, since both groups are relatively larger in our present population. Latent syphilis requires no more or no different treatment than does early syphilis. A total dosage of 4,800,000 units of procaine penicillin G in oil and aluminum monostearate or half of this amount of benzyathine penicillin G is adequate for both. It is not the goal to obtain seronegativity in the treatment of the patient with latent syphilis since seronegativity may or may not occur within the patient's lifetime. The TPI test is a better indicator of the immunological status of the luetic patient, after the test has once become reactive.
Curtis AC, Schuster DS. THE LABORATORY DIAGNOSIS, BIOLOGY, AND TREATMENT OF LATENT SYPHILIS. JAMA. 1958;167(5):560–562. doi:10.1001/jama.1958.02990220030009
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