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QUESTION 11
A 45-year-old male is referred to you because his serum RPR is positive. He reports that he was treated for syphilis 15 years ago with penicillin: he does not remember his serologic titer or the details of his treatment.
He has had “a few” sexual partners over the past 25 years but recalls no chancres, STDs, or other manifestations suggestive of syphilis.
He is healthy, has a normal physical exam, and normal screening laboratory tests.
Serologies: RPR = 1:64, FTA= positive, HIV ELISA negative
Which of the following would be the best recommendation regarding syphilis management presuming that the patient refuses an LP?
(1) No further serologic follow up or treatmen
(2) Treat with one dose of benzathine pencillin
(3) Treat with three doses of benzathine pencillin
(4) Treat with benazathine penicillin for 10-14 days
(5) Treat with IV penicillin for 10-14 days
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