syphilis question

Lets see, 30 years ago, pre HIV/Aids. But has she continued to be sexually active, has she had children?

I would think testing for every STD would be the safest way to go.

Can you imagine trying to track down her contacts? She sounds like a public health nightmare.

I have a question, if a patient has been diagnosed with syphilis over 30 years ago and refuses treatment b/c she denies ever contracting the disease, is there any other specific STDs that she should be tested for related to syphilis?

Other STD's including PID.

I believe after this long she would be asymptomatic, unless she is showing neurological signs (tertiary stage.)

Also, I don't think she is contagious after the first year, (some are in the second stage, but she seems far past that).

I think she could be treated w/ antibiotics but don't think they would stop the progression of the disease since the damage to the brain is irreversible.

Hows her heart? Seem to remember that Syphilis can affect the heart as well as the brain.

Neurological and cardiac problems will be presented with underlying cause of syphillis. Seem to remember some arthritic problems with a patient that doctor related to syphillis too. I have had several patients like this, senile dementia was detected very early and very untreatable. One patient had 2 severely retarded sons . It was a a very sad case.

Lets see, 30 years ago, pre HIV/Aids. But has she continued to be sexually active, has she had children?

I would think testing for every STD would be the safest way to go.

Can you imagine trying to track down her contacts? She sounds like a public health nightmare.

:yeahthat:

If the patient is having further deteriorating symptoms, which she must be having since it has resulted in her diagnosis, then she is definitely is still infectious in some form. She will need antibiotic treatment to prevent further deterioration of her condition. If one of the conditions she has developed is neuro syphilis, treatment will not reverse the permanent brain damage that has already occurred. There was a recent very good episode of House about a woman who contracted syphilis 30 years ago and her only presenting symptoms was a change in libido.

I have had three large blood and spinal fluid exposures to patients with tertiary syphilis and it is considered very infectious.

Syphilis is named the great mimic because it can be misdiagnosis as any disease. One movie I show my students is Mrs. Evers' Boys about the Tuskegee Experiment.