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. 1983 Aug;59(4):225–227. doi: 10.1136/sti.59.4.225

Treatment of neurosyphilis with chloramphenicol. A case report.

B Romanowski, E Starreveld, A J Jarema
PMCID: PMC1046188  PMID: 6871651

Abstract

Although penicillin is the drug of choice in syphilis, treatment failures with benzathine and procaine penicillin have occurred in neurosyphilis. Patients allergic to penicillin have traditionally been treated with tetracycline but, since this drug diffuses poorly into the cerebrospinal fluid, its use in neurosyphilis is uncertain. In the case reported here, a penicillin allergic patient with general paresis of the insane was successfully treated with chloramphenicol. This drug has been used in the treatment of syphilis and achieves high concentrations in the cerebrospinal fluid. Thus chloramphenicol may be a more appropriate agent than tetracycline in treating patients with neurosyphilis who are allergic to penicillin.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barza M., Schiefe R. T. Antimicrobial spectrum, pharmacology and therapeutic use of antibiotics. Part 1: tetracyclines. Am J Hosp Pharm. 1977 Jan;34(1):49–57. [PubMed] [Google Scholar]
  2. Catterall R. D. Neurosyphilis. Br J Hosp Med. 1977 Jun;17(6):585–604. [PubMed] [Google Scholar]
  3. Ducas J., Robson H. G. Cerebrospinal fluid penicillin levels during therapy for latent syphilis. JAMA. 1981 Dec 4;246(22):2583–2584. [PubMed] [Google Scholar]
  4. Giles A. J. Tabes dorsalis progressing to general paresis after 20 years despite routine penicillin therapy. Br J Vener Dis. 1980 Dec;56(6):368–371. doi: 10.1136/sti.56.6.368. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hooshmand H., Escobar M. R., Kopf S. W. Neurosyphilis. A study of 241 patients. JAMA. 1972 Feb;219(6):726–729. doi: 10.1001/jama.219.6.726. [DOI] [PubMed] [Google Scholar]
  6. MONTGOMERY C. H., KNOX J. M. Antibiotics other than penicillin in the treatment of syphilis. N Engl J Med. 1959 Aug 6;261(6):277–280. doi: 10.1056/NEJM195908062610605. [DOI] [PubMed] [Google Scholar]
  7. McGeeney T., Yount F., Hinthorn D. R., Liu C. Utility of the FTA-Abs test of cerebrospinal fluid in the diagnosis of neurosyphilis. Sex Transm Dis. 1979 Jul-Sep;6(3):195–198. doi: 10.1097/00007435-197907000-00001. [DOI] [PubMed] [Google Scholar]
  8. Mohr J. A., Griffiths W., Jackson R., Saadah H., Bird P., Riddle J. Neurosyphilis and penicillin levels in cerebrospinal fluid. JAMA. 1976 Nov 8;236(19):2208–2209. [PubMed] [Google Scholar]
  9. Nordenbo A. M., Sørensen P. S. The incidence and clinical presentation of neurosyphilis in Greater Copenhagen 1974 through 1978. Acta Neurol Scand. 1981 Apr;63(4):237–246. doi: 10.1111/j.1600-0404.1981.tb00777.x. [DOI] [PubMed] [Google Scholar]
  10. Polnikorn N., Witoonpanich R., Vorachit M., Vejjajiva S., Vejjajiva A. Penicillin concentrations in cerebrospinal fluid after different treatment regimens for syphilis. Br J Vener Dis. 1980 Dec;56(6):363–367. doi: 10.1136/sti.56.6.363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. ROMANSKY M. J., OLANSKY S., TAGGART S. R., LANDMAN G. S., ROBIN E. D. Chloromycetin (chloramphenicol) in the treatment of various types of syphilis; a preliminary follow-up. Am J Syph Gonorrhea Vener Dis. 1951 May;35(3):234–239. [PubMed] [Google Scholar]
  12. TAGGART S. R., ROMANSKY M. J., LANDMAN G. S. Treatment of syphilis with aureomycin and chloromycetin. Am J Syph Gonorrhea Vener Dis. 1952 Mar;36(2):174–178. [PubMed] [Google Scholar]
  13. Tramont E. C. Persistence of Treponema pallidum following penicillin G therapy. Report of two cases. JAMA. 1976 Nov 8;236(19):2206–2207. [PubMed] [Google Scholar]
  14. Wilner E., Brody J. A. Prognosis of general paresis after treatment. Lancet. 1968 Dec 28;2(7583):1370–1371. doi: 10.1016/s0140-6736(68)92674-3. [DOI] [PubMed] [Google Scholar]
  15. Yoder F. W. Penicillin treatment of neurosyphilis. Are recommended dosages sufficient? JAMA. 1975 Apr 21;232(3):270–271. [PubMed] [Google Scholar]

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