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STDs (Expert Forum)
Possible Neuro Syphilis ? Tertiary Syphilis? Questions and Options
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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Possible Neuro Syphilis ? Tertiary Syphilis? Questions and Options
by WebSerf1, Aug 31, 2005 12:00AM
Hello, I know this will be long but I want to present my history so as to get a helpful response from anyone with knowledge!
I am giving a long history, and the questions I need answered are in the last 4-5 paragraphs. Thanks...
Back in 1980 (20yrs old), I 'dated' a girl for about 4 months during which time I took sick with the following symptoms and diagnosis:
•Rash on my face (cannot remember what they called it)
•Oral thrush
•Penile Discharge (yellowish)
•Extreme fatigue
I was sick for about a week, with flu-like weakness/aches. I don't remember being diagnosed with an STD, (nor did I have the 'classic' sore) but was given a shot of penecilin and a course of pills. After a few days all cleared up, but I did continue to 'date' this girl for a month or 2.
I remember having a bout of the "flu", about 2 years later, that kept me in bed for a few days, and later, (1985) was diagnosed with an arrhythmia (SVT). And later diagnosed with Pain Dominent IBS. That is the extent of my illnesses over the course of 25 years. I still deal with the SVT, and in recent months I had attacks lasting for weeks. I've taken anti-biotics maybe 3 times in 25 years. I take Lorcet for the bad bouts of IBS. I have on occasion taken them for longer periods, to control IBS and for stress relief.
Going back to 1980-84, I had several mostly short term relationships of 6 months or longer. I don't beleive I passed "anything" on to anyone during this time nor have I had reason to believe I had any disease. I got married in 1986, and have been 100% faithful. Wife is healthy. Kids Healthy.
Current Medical History....
•Colonoscopy clear (2003)
•Full Vascular study (2004)found no abnormalities except pre-hypertension. 134-80
•Brain MRI w/contrast unremarkable.
•Recent Blood tests for RPR negative, LYME negative, HIV and HTLIV negative. The lab overlooked the FTA. Waiting for those results now. Just anxious, and not sure if I want a negative or positive result. I just want to get well and start a course of cure..
WHY I am concerned about Neuro Syphilis. One, no other diagnosis as of this date.
In the last 18 months, I have had several issues which all started with a severe lower abdominal attack of pain lasting a week. I recovered from this (undiagnosed but later a clear abdominal CT with contrast). GI's post event diagnosis was something like acute Gall Bladder dumping. A month after the attack I started having several other issues and they continue today.
•More frequent SVT attacks.
•Vision disturbances (blurry, halos)(really worried but doc says eyes healthy)
•Dizziness, Faintness, Fatigue, inability to get good rest.
•Numbness Tingling of extremities, and sensitive skin and muscles.
•Depression, and Anxiety to go along.
•NO zest for life.
I do have a relatively normal sex drive except on my bad days of dizziness and such. I feel this is an important factor.
OK FINALLY the Questions about how to rule this out or in.
WHAT tests will help me to clearly rule this out or in, and if I have it, can you advise the best course of action to get rid of it?
If the FTA is negative, could I still have Neuro Syphilis? Do I have to do a Lumbar Puncture? Or if serum FTA negative I can rest easy? Are there any other blood related tests I Should ask for? Is an FTA-ABS the same as an FTA?
I know this was long, but I am concerned that the doctors just want me to live with all these symptoms. They are writing it of to Anxiety, and Depression. Yes, I am depressed as I haven't felt normal for going on 2 years.
Please any help or advise would be appreciated. I realize too that I could be battling more than one medical issue. One doctor is writing it off to a "post viral fatigue syndrome". It that is the case, HOW long do I deal with that?
Thank you all in advance. And thank you for your patience in reading this...
Ron
I am giving a long history, and the questions I need answered are in the last 4-5 paragraphs. Thanks...
Back in 1980 (20yrs old), I 'dated' a girl for about 4 months during which time I took sick with the following symptoms and diagnosis:
•Rash on my face (cannot remember what they called it)
•Oral thrush
•Penile Discharge (yellowish)
•Extreme fatigue
I was sick for about a week, with flu-like weakness/aches. I don't remember being diagnosed with an STD, (nor did I have the 'classic' sore) but was given a shot of penecilin and a course of pills. After a few days all cleared up, but I did continue to 'date' this girl for a month or 2.
I remember having a bout of the "flu", about 2 years later, that kept me in bed for a few days, and later, (1985) was diagnosed with an arrhythmia (SVT). And later diagnosed with Pain Dominent IBS. That is the extent of my illnesses over the course of 25 years. I still deal with the SVT, and in recent months I had attacks lasting for weeks. I've taken anti-biotics maybe 3 times in 25 years. I take Lorcet for the bad bouts of IBS. I have on occasion taken them for longer periods, to control IBS and for stress relief.
Going back to 1980-84, I had several mostly short term relationships of 6 months or longer. I don't beleive I passed "anything" on to anyone during this time nor have I had reason to believe I had any disease. I got married in 1986, and have been 100% faithful. Wife is healthy. Kids Healthy.
Current Medical History....
•Colonoscopy clear (2003)
•Full Vascular study (2004)found no abnormalities except pre-hypertension. 134-80
•Brain MRI w/contrast unremarkable.
•Recent Blood tests for RPR negative, LYME negative, HIV and HTLIV negative. The lab overlooked the FTA. Waiting for those results now. Just anxious, and not sure if I want a negative or positive result. I just want to get well and start a course of cure..
WHY I am concerned about Neuro Syphilis. One, no other diagnosis as of this date.
In the last 18 months, I have had several issues which all started with a severe lower abdominal attack of pain lasting a week. I recovered from this (undiagnosed but later a clear abdominal CT with contrast). GI's post event diagnosis was something like acute Gall Bladder dumping. A month after the attack I started having several other issues and they continue today.
•More frequent SVT attacks.
•Vision disturbances (blurry, halos)(really worried but doc says eyes healthy)
•Dizziness, Faintness, Fatigue, inability to get good rest.
•Numbness Tingling of extremities, and sensitive skin and muscles.
•Depression, and Anxiety to go along.
•NO zest for life.
I do have a relatively normal sex drive except on my bad days of dizziness and such. I feel this is an important factor.
OK FINALLY the Questions about how to rule this out or in.
WHAT tests will help me to clearly rule this out or in, and if I have it, can you advise the best course of action to get rid of it?
If the FTA is negative, could I still have Neuro Syphilis? Do I have to do a Lumbar Puncture? Or if serum FTA negative I can rest easy? Are there any other blood related tests I Should ask for? Is an FTA-ABS the same as an FTA?
I know this was long, but I am concerned that the doctors just want me to live with all these symptoms. They are writing it of to Anxiety, and Depression. Yes, I am depressed as I haven't felt normal for going on 2 years.
Please any help or advise would be appreciated. I realize too that I could be battling more than one medical issue. One doctor is writing it off to a "post viral fatigue syndrome". It that is the case, HOW long do I deal with that?
Thank you all in advance. And thank you for your patience in reading this...
Ron
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 31, 2005 12:00AM
, Aug 31, 2005 12:00AM
Your symptoms do not remotely suggest neurosyphilis, and your distant health problems (back to 1980) don't sound like syphilis either. Further, active neurosyphilis is extremely rare in the absence of a postive rapid plasma reagin (RPR) test.
The FTA-ABS test replaced the older FTA method 20-30 years ago. Even the FTA-ABS is rarely done anymore; other syphilis-specific tests are used to confirm positive RPR results. The most common currently in use is called TPPA, for "Treponema pallidum Particle Agglutination". But neither TPPA nor FTA-ABS is recommended when the RPR is negative. Even if you had a positive result, it would not necessarily mean you actually had neuro (or any other form of) syphilis. That said, it probably wouldn't do much harm; if negative, which it probably will be, perhaps it would put your mind at ease better than my words can do. But be aware of the possibility of a false-positive result.
I would not presume to provide specific advice to you about how to deal with your symptoms except to say I suspect your doctors are right both in their diagnosis and advice. In any case, you can put neurosyphilis out of your mind.
Good luck-- HHH, MD
The FTA-ABS test replaced the older FTA method 20-30 years ago. Even the FTA-ABS is rarely done anymore; other syphilis-specific tests are used to confirm positive RPR results. The most common currently in use is called TPPA, for "Treponema pallidum Particle Agglutination". But neither TPPA nor FTA-ABS is recommended when the RPR is negative. Even if you had a positive result, it would not necessarily mean you actually had neuro (or any other form of) syphilis. That said, it probably wouldn't do much harm; if negative, which it probably will be, perhaps it would put your mind at ease better than my words can do. But be aware of the possibility of a false-positive result.
I would not presume to provide specific advice to you about how to deal with your symptoms except to say I suspect your doctors are right both in their diagnosis and advice. In any case, you can put neurosyphilis out of your mind.
Good luck-- HHH, MD
I am aware of a possible "false positive".
ONE THING, I had read that a negative RPR so late in the game is likely (and expected)in Tertiary, Latent, and Neuro cases. Do you agree or no? My point is that the damage is done, and the Bacteria lays back undetected. Just a thought. I respect your input.
When the FTA comes back, and if negative, I will leave it to rest, and focus on the Mental aspect of recovery. The physical symptoms are real, and debilitating sometimes.
If positive, I may opt for a second test, and then move from there.
Again many thanks,
Ron
HHH, MD
...and it certainly puts my mind at ease as far as any late stage Syphilis.
It has been hard trying to get to the bottom of what I do have, as being Dizzy/Faint, Tired, Anxious, Etc, EVERY DAY, can take 'it' out of you... An occasional Ativan helps but NEVER rids me of the problem for any length of time. Moreover, I rarely get relief from the symptoms, leaving me to believe it is more than just Anxiety-Related Disorder.
Again...
Thanks again for your time on this.
Best Wishes,
Ron