A 38-year-old woman was referred to clinic for treatment of otosyphilis. She reported a relatively sudden decrease in hearing in her left ear. Her examination was only notable for sensorineural hearing loss in the left ear, with no neurologic symptoms or signs. Laboratory studies included serologic syphilis testing, and results showed a positive enzyme immunoassay (EIA) and a positive Rapid Plasma Reagin (RPR), with a titer of 1:64. She does not have a penicillin allergy. Which one of the following is the preferred treatment of otosyphilis in this individual?
A) Benzathine penicillin G administered as 2.4 million units intramuscularly as a single dose B) Benzathine penicillin G administered as 2.4 million units intramuscularly weekly for 3 doses C) Aqueous crystalline penicillin G 18 to 24 million units per day, administered as 3 to 4 million units intravenous every 4 hours (or continuous infusion), for 10 to 14 days D) A lumbar puncture should be performed with cerebrospinal fluid analysis and the treatment regimen based on the results
