Data from ref. 2.

Data from ref. 2.

heimer reaction is uterine contractions; therefore, some suggest fetal monitoring before initiation of penicillin therapy in patients in the third trimester (27).

There is no documented evidence of T. pallidum resistance to penicillin (25,27).

Other Genital Ulcerative Diseases

Granuloma inguinale and lymphogranuloma venereum (LGV) are rare diseases in the United States. Treatment with 100 mg of doxycycline twice a day for 3 wk is recommended; further information can be found in the recent CDC guidelines (2).

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