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STDs (Expert Forum)
Testing for Neurosyphilis
Answered by
Edward W Hook, MD - HIV Prevention, stds
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IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Testing for Neurosyphilis
by cillus, Mar 11, 2008 01:38PM
Dear Doctor,
15 months ago I had a general malaise, feeling of tiredness, a stiff neck, perturbed sleep patterns, and gradual weight loss followed by a rash in my hands and soles. That's when I was diagnosed with stage 2 shyphilis. I got the classic treatment (one shot of penicilin) and my titre went down from an initial 1:512 to 1:1 in 9 months. It is now still in 1:1. To note, repeated tests all came back negative for all other stds.
However, the neck stiffness still comes and goes, at times with a dull ache at the base of my skull. And I often wake up tired even after a full night sleep and don't quite feel 100%.
Would you advise getting a lumbar puncture to test for signs of neurosyphilis? Could one be cured from "regular" syphilis but not neurosyphilis?
15 months ago I had a general malaise, feeling of tiredness, a stiff neck, perturbed sleep patterns, and gradual weight loss followed by a rash in my hands and soles. That's when I was diagnosed with stage 2 shyphilis. I got the classic treatment (one shot of penicilin) and my titre went down from an initial 1:512 to 1:1 in 9 months. It is now still in 1:1. To note, repeated tests all came back negative for all other stds.
However, the neck stiffness still comes and goes, at times with a dull ache at the base of my skull. And I often wake up tired even after a full night sleep and don't quite feel 100%.
Would you advise getting a lumbar puncture to test for signs of neurosyphilis? Could one be cured from "regular" syphilis but not neurosyphilis?
Doctor's Answer
by Edward W Hook, MD, Mar 11, 2008 02:31PM
, Mar 11, 2008 02:31PM
To: cillus
Your blood tests show an excellent response to therapy making it unlikely that you have neurosyphilis. In over 20% of patients with syphilis the blood test results may not go to 0 (or even change at all). While there are very rare instances of neurosyphilis following apparent response to treatment, the neurosyphilis is usually accompanied by blood tests results which start to rise again. Could your symptoms be due to something else (?depression?). If you were my patient, I would be content to watch you unless your blood tests began to rise or your symptoms progressed. I hope this is helpful EWH
