Review of Current Evidence and Comparison of Guidelines for ...

EUR/03/5045931
page 42
Treatment of acquired syphilis of children
Treatment is carried out according to the treatment methods for adults considering the diagnosis
and child’s age. It is significant that children under two years of age should not be treated with
domestic bicillin, as well as children under eight years should not be treated with tetracycline.
Preventive treatment of children
Same methods and same preparations as for adult treatment are used here, except for domestic
bicillines for children under two years, and tetracycline preparations for children under eight
years.
12. Clinical and serological control over the end of the treatment
Adults and children who have received preventive treatment after sexual or close household
contact with a person having early forms of syphilis, are subjected to unitary clinical serological
tests in three months after the treatment.
Patients with primary seronegative syphilis should also be observed for three months.
Patients with early forms of the syphilis, who had positive Wassermann results before treatment,
should be subjected to clinical serological control until its complete negativation and after that
six more months; two serologic blood testing should be done while then. The duration of clinical
and serological control is individual depending on the treatment results.
For patients with late forms of syphilis at whom Wassermann reactions after treatment quite
often remains positive, it is stipulated obligatory three years term of clinical and serological
control. The decision on removal from the registration or prolongation of the control is accepted
individually. During control supervision Wassermann reactions (WR) investigate one time in six
months within the second and third year. Specific serology reactions (FTAabs, ELISA, TPHA)
are tested once a year.
Patients with neurosyphilis irrespective of its stage should be supervised for three years. Results
of treatment are observed considering blood serum tests within the terms which have been
mentioned above, and also by obligatory liquor testing on its dynamics. The first liquor control
should be done in six months after the treatment. If the sanitation of liquor on cells quantity and
serology parameters is absent then one more treatment course should be done (antibiotics are
likely to be effective only if pathology is present in liquor)
The further control of spinal liquid condition is done once in six months, within the limits of
three years of supervision after a patient has been diagnosed.
Stable liquor normalization even if clinical defect is still present can be a reason to remove a
person from registration.
Serofast patients should be under clinical serological control for three years.
Children delivered to syphilis infected mothers but having no congenital syphilis themselves
should go through clinical serology control during one year irrespective whether they received
preventive treatment or not. The first clinical serology examination is carried out at the age of
three months; besides, clinical examination of pediatrist, consultation of neuropathologist, the
oculist, the otolaryngologist, serological tests – (Microreaction of precipitation (VDRL type),