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Health Advisory: STD/HIV Treatment During COVID-19 Pandemic Response

Published March 31, 2020.

Requested actions

To avoid COVID-19 exposure for high-risk groups and lessen the burden on the healthcare system, take the following actions for neurosyphilis and ocular syphilis testing and treatment.

  • Refer patients who need a lumbar puncture to radiology or neurology, rather than the emergency department.
  • Consider second line therapy for the following patients with diagnostic findings consistent with neurosyphilis or ocular syphilis.
    • Cognitive dysfunction, motor or sensory deficits, ophthalmic or auditory symptoms, cranial nerve palsies.
    • Syphilitic uveitis or other ocular manifestations (e.g., neuroretinitis and optic neuritis).

Background

Emergency departments are overwhelmed with COVID-19 patients. Some patients with neurosyphilis or ocular syphilis may have concomitant HIV infection and may be immunocompromised.

First line therapy with IV penicillin G requires an inpatient or emergency department visit. To lessen the burden for hospitals and to avoid COVID-19 exposure for high-risk groups, providers should manage these patients in outpatient settings. Use the following second line treatment regimen, if compliance can be ensured.

Procaine penicillin G 2.4 million units IM once daily for 10-14 days,
plus
Probenecid 500 mg orally 4 times daily for 10-14 days.

Report STD cases

Healthcare providers and facilities must report HIV/AIDS and most other STDs within 3 business days.

Questions?

Call us at (253) 798-6534.

 

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