Oral doxycycline as an alternative treatment for early neurosyphilis in a patient living with HIV
DOI:
https://doi.org/10.5935/2764-734X.e20240947Keywords:
Neurosyphilis, HIV infections, Doxycycline, Case reportAbstract
This report aims to describe the successful treatment using oral doxycycline for early neurosyphilis in a patient living with HIV, primarily presenting with skin lesions. The therapeutic proposal, chosen by the patient and based on UK medical guidelines, has not yet been validated by the Brazilian Ministry of Health. The treatment consisted of a single dose of penicillin G benzathine (2.4 million units) administered intramuscularly, followed by oral doxycycline (200 mg twice a day) for 28 days, with quarterly outpatient follow-up. The patient's symptoms resolved on the first visit, and the nontreponemal test (VDRL) in the cerebrospinal fluid was negative after 6 months. The current literature offers inconclusive results; however, this case suggests that oral doxycycline is a safe alternative for treating neurosyphilis in select cases, especially for patients with penicillin allergies, while providing the advantage of avoiding hospitalization.
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