238 Where There Is No Doctor 2011
• Weeks or months later, there may be sore throat, mild fever, mouth sores, or swollen
joints. Or any of these signs may appear on the skin:
a painful rash or ‘pimples’
all over the body
ring-shaped welts
(like hives)
an itchy rash on the
hands or feet
All of these signs usually go away by themselves, making the person think he is well—
but the disease continues. Without adequate treatment, syphilis can invade any part
of the body, causing heart disease, paralysis, insanity, and many other problems.
Note: Yaws shares many of the same signs as syphilis (see p. 202).
CAUTION: If any strange rash or skin condition shows up days or weeks after a pimple or
sore appears on the genitals, it may be syphilis. Get medical advice.
Treatment for syphilis: (For complete cure, the full treatment is essential.)
♦ If signs have been present less than 1 year, inject 2.4 million units of benzathine
penicillin all at once, half the dose in each buttock (see p. 352). If allergic to penicillin,
take tetracycline or erythromycin by mouth, 500 mg., 4 times a day for 15 days.
♦ If signs have been present more than 1 year, inject 2.4 million units of benzathine
penicillin—half in each buttock—once a week for 3 weeks, for a total of 7.2 million
units. If allergic to penicillin, take either tetracycline or erythromycin, 500 mg., 4
times each day for 30 days.
♦ If there is any chance that someone has syphilis, she should immediately see a
health worker. Special blood tests may be needed. If tests cannot be made, the
person should be treated for syphilis in any case.
♦ Everyone who has had sexual contact with a person known to have syphilis should
also be treated, especially husbands or wives of those known to be infected.
Note: Pregnant or breastfeeding women who are allergic to penicillin can take
erythromycin in the same dosage as tetracycline (see p. 355).
To prevent syphilis, see the next page.
Bubos: Bursting Lymph Nodes in the Groin
(Lymphogranuloma Venereum)
Signs:
• In a man: Large, dark lumps in the groin that open to drain
pus, scar up, and open again.
• In a woman: Lymph nodes similar to those in the man. Or
painful, oozing sores in the anus.
Treatment:
♦ See a health worker.
♦ Give adults 500 mg. of erythromycin, 4 times a day for 14 to 21 days. Or give
doxycycline, 100 mg., 2 times a day for 14 to 21 days.
♦ Avoid sex until the sores are completely healed.
Note: Bubos in the groin can also be a sign of chancroid (see p. 403).