BACKGROUND Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. In low- and middle-income countries in Asia and Latin America, 20%-30% of women are not tested for syphilis during pregnancy. We evaluated the cost-effectiveness of increasing the coverage for antenatal syphilis screening in 11 Asian and 20 Latin American countries, using a point-of-care immun...

BACKGROUND Beta-lactam antibiotics are the most frequent drugs prescribed in children worldwide. Acute rheumatic fever (ARF) is the major cause of acquired heart disease among children and adolescents. Recurrences due to inadequate penicillin prophylaxis are responsible for chronic valvular lesions requiring surgery. The fear of a severe allergic reaction is the leading cause of discontinuing p...

Background Some syphilitic patients remain in a serologically positive state after the recommended therapy. Although we often retreat patients in clinical practice, the optimal treatment protocol remains uncertain due to the paucity of data regarding serological response to retreatment and long-term outcomes. Methods We examined rapid plasma reagin serological test results of 70 serofast earl...

In the article by Mohanan Nair et al, “A Case of Rheumatic Fibrinous Pericarditis,” which appeared in the December 2016 issue of the journal (Circ Cardiovasc Imaging. 2016;9:e005399. DOI: 10.1161/CIRCIMAGING.116.005399), a correction is needed. On page 1, the second sentence should read: “He provided history of rheumatic fever in the past and was on intramuscular benzathine penicillin prophylax...

BACKGROUND Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) contribute to Aboriginal Australian and Torres Strait Islander health disadvantage. At the time of this study, specialist ARF/RHD care in the Kimberley region of Western Australia was delivered by a broad range of providers. In contrast, in Far North Queensland (FNQ), a single-provider model was used as part of a coordinat...

CONTEXT During the last 12 years we have observed an increase in the frequency of Sydenham's chorea in our country. We have observed that some of our patients have presented recurrence of the chorea despite regular treatment with benzathine penicillin. OBJECTIVE The aim of our study was to evaluate clinical and evolutive characteristics of Sydenham's chorea in a group of patients followed in ...

Nicolau syndrome (NS) or livedo-like dermatitis is a rare complication of injection of various medications such as penicillin. The pathophysiology of this events is not clear, but some hypotheses are suggested, such as sympathetic nerve stimulation, embolic occlusion, inflammation, or mechanical injury. In this paper we report 3 cases of NS following benzathine penicillin. Clinical symptoms imp...

INTRODUCTION Rheumatic heart disease (RHD) frequently occurs following recurrent episodes of acute rheumatic fever (ARF). Benzathine penicillin (benzapen) is the most effective method for secondary prophylaxis against ARF whose efficacy largely depends on adherence to treatment. Various factors determine adherence to therapy but there are no data regarding current use of benzapen in patients wi...

Although penicillin is the drug of choice in syphilis, treatment failures with benzathine and procaine penicillin have occurred in neurosyphilis. Patients allergic to penicillin have traditionally been treated with tetracycline but, since this drug diffuses poorly into the cerebrospinal fluid, its use in neurosyphilis is uncertain. In the case reported here, a penicillin allergic patient with g...

The search for an orally administered and stable penicillin preparation with high therapeutic efficacy led to the recent discovery that the benzyl ester of penicillin, given orally, was at least equal in protective effect to the equivalent weight of sodium penicillin administered parenterally to mice that had received lethal doses of pneumococci and hemolytic streptococci by intraperitoneal inj...