The 24-year-old patient presents with flu-like symptoms and a diffuse maculopapular rash across her chest, trunk, and palms of the hands. Upon palpation, cervical lymph nodes are enlarged. The patient uses intravenous drugs and reports having unprotected sex. The patient’s labs are notable for negative HIV test, positive human chorionic gonadotropin test, and positive rapid plasma reagin test. The patient reports a history of anaphylaxis with penicillin administration. The nurse educates the patient about which treatment?

Question

The 24-year-old patient presents with flu-like symptoms and a diffuse maculopapular rash across her chest, trunk, and palms of the hands. Upon palpation, cervical lymph nodes are enlarged. The patient uses intravenous drugs and reports having unprotected sex. The patient&rsquo;s labs are notable for negative HIV test, positive human chorionic gonadotropin test, and positive rapid plasma reagin test. The patient reports a history of anaphylaxis with penicillin administration. The nurse educates the patient about which treatment?

Accepted Answer

Penicillin desensitization followed by penicillin G for one dose. The pregnant patient with secondary syphilis must be treated with penicillin desensitization followed by one dose of penicillin G. Tetracycline is contraindicated in pregnancy. Ceftriaxone is less effective at eradicating the infection. Diphenhydramine is not sufficient to prepare the patient who experienced anaphylaxis. Additionally, penicillin VK is not the appropriate form of the drug.

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