Relapse Following Penicillin Therapy of Early Syphilis. Presented by Dr. Willard M. Meininger.
G. M., a 20 year old single Negro, had positive results of dark field examination, a positive serologic reaction and a genital primary syphilitic lesion in November 1944. His cerebrospinal fluid was normal. He entered Stanford University Hospital on November 15, and his chancre promptly, healed with the administration of 1,200,000 units of penicillin given intramuscularly in doses of 80,000 units at six hour intervals. The prepenicillin Kolmer quantitative titer of the blood was 8 units, and the titer remained at that level through Jan. 5, 1945.He returned for a routine check-up on January 23, with a monorecurrence in which Treponema pallidum was demonstrated. His serologic titer had risen to 32 units. The cerebrospinal fluid was still normal. He then received 40,000 units of penicillin intramuscularly every three hours for sixty doses, totaling 2,400,000 units.The