**8. Follow-Up**

Clinical and serologic investigations should be needed within 12 months of treatment; if conditions for follow-up are uncertain more frequent evaluation might be prudent. Assessing serologic response to treatment can be difficult, and definitive criteria for evaluating treatment outcomes by serologic criteria have not been well established [33].

In addition, nontreponemal test titers might decrease more slowly for persons previously treated for syphilis. Among individuals with neurologic findings without any reported sexual exposure during the previous 3–6 months indicating that treatment failure might be possible, a cerebral spinal fluid examination is recommended, and should also be reevaluated for HIV infection [34].
