Late neurosyphilis is a serious manifestation of tertiary syphilis requiring a specific parenteral antibiotic approach. This protocol covers the treatment of patients without penicillin allergy who present with the spectrum of late neurosyphilitic syndromes.
Late neurosyphilis encompasses meningitis, cranial nerve dysfunction, meningo-vascular syphilis (presenting as stroke or myelitis), and parenchymatous neurosyphilis — including general paresis and tabes dorsalis. This protocol applies in the absence of penicillin allergy.
Parenteral antibiotic therapy is the basis of treatment for late neurosyphilis. Where standard intravenous therapy in a hospital setting is not possible, an alternative parenteral regimen is recommended. The specific agent selection, regimen structure, and treatment duration are detailed in the full protocol.
Complete regimen — including agent choice, dosing schedule, and duration — is available via the link below.
DOI: 10.1111/jdv.16946