Question

What do you do with a pregnant patient who tests positive for syphilis but has a penicillin allergy?

Answer 1

A pregnant patient who tests positive for syphilis but has a penicillin allergy should undergo desensitization to receive penicillin. If desensitization is not suitable, alternatives like tetracycline or doxycycline may be used, though with less efficacy and the need for careful monitoring and retesting.

Step-by-step explanation:

If a pregnant patient tests positive for syphilis but is allergic to penicillin, the typical treatment, a strategy called desensitization is required. Desensitization involves administering small doses of penicillin under controlled conditions to make the patient's immune system tolerant to the drug. Penicillin is especially crucial for pregnant women since it has a 98 percent success rate at preventing transmission of syphilis from mother to fetus. If desensitization is not an option or if the patient refuses, alternative treatments like tetracycline or doxycycline may be considered; however, they tend to be less effective and require thorough follow-up and retesting for syphilis after treatment.

Answer 2

Desensitization is required for a pregnant patient with a penicillin allergy who tests positive for syphilis. Once desensitized, penicillin can be safely administered to treat the infection and prevent transmission to the fetus.

Step-by-step explanation:

If a pregnant patient tests positive for syphilis but has a penicillin allergy, desensitization is required before treatment is given. Desensitization involves gradually exposing the patient to small amounts of the allergen (penicillin) under medical supervision to reduce the allergic reaction. Once the patient is desensitized, penicillin can be safely administered to treat the syphilis infection and prevent transmission to the fetus.