In a patient with a local genital lesion thought to be syphilitic, treatment of syphilis should be withheld until dark ground examination is completed. Treatment for coexistent gonorrhoea or NGU should not be delayed but a non-treponemicidal drug such as spectinomycin or trimethoprim-sulphamethoxazole should be used.
The patient should be told the diagnosis, the natural history of syphilis and the need for compliance with treatment and for regular follow up with clinical examination and repeat serological tests.
The cooperation of the patient in the following up of known contacts should be sought at an early stage.
Notification of cases of syphilis is required in all States and Territories although the name and address of a patient is not required unless the patient defaults.
The patient should avoid sexual intercourse until all lesions have healed and until the antibiotic course is complete.