A 30 year old woman who is pregnant presents to your clinic with positive syphilis screening. She is currently in her third trimester (30 weeks gestational age). She is currently asymptomatic but recalls a painless ulcer near her vagina about eight weeks ago that has since disappeared. She denies any current rash, hair loss, swollen lymph nodes, vision or hearing changes. Her syphilis screen during first trimester of this pregnancy was negative.
She has no other medical history and denies any recent antimicrobial treatment. She reports an allergy to penicillin with hives and lip swelling.
Her syphilis enzyme immunoassay (EIA) and Treponema pallidum particle agglutination (TPPA) are reactive and her rapid plasma reagin (RPR) is 1:128.