The patient with early syphilis should return for repeat examination and serology at the following intervals:
at one month;
at regular 3 monthly intervals for 1 year, and
at 6 monthly intervals for the second year.
Patients with late syphilis should be followed indefinitely; patients with neurosyphilis should have periodic CSF examinations for at least 3 years.
The titre of the reagin test (VDRL or RPR) will fall until it becomes non-reactive or minimally reactive (e.g. 1/2) by the end of 2 years after effective treatment of early syphilis.
In late syphilis, low titres are usually found and only a slight reduction should be expected after treatment. In some cases, no change in titre occurs. Provided the CSF has been tested and found to be non-reactive, no further treatment is indicated.
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