Neurology Exam Prep Podcast Episode 74 - Neurosyphilis
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Dec 31, 2024 In this engaging discussion, Dr. Aaron Bower, an attending physician at Yale specializing in neuroimmunology, delves into the complexities of neurosyphilis. He describes the distinct stages of syphilis and its alarming rise in incidence, especially in the context of HIV co-infection. Dr. Bower highlights both early and late neurological manifestations, including syphilitic meningitis and complications like tabes dorsalis. The conversation also covers diagnostic approaches and CDC-recommended treatment protocols, emphasizing the critical need for effective monitoring.
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Syphilis Resurgence & HIV Co-infection
- Syphilis rates, including neurosyphilis, are increasing in the U.S., especially among men.
- Co-infection with HIV is high (42%), so test for both.
Syphilis Transmission and Stages
- Syphilis is caused by the spirochete Treponema pallidum, transmitted sexually or vertically.
- Early syphilis (within 1-2 years) is distinguished from late syphilis (beyond 2 years).
Primary and Secondary Syphilis
- Primary syphilis (<3 weeks): Painless chancre(s), regional lymphadenopathy.
- Secondary syphilis (6-8 weeks post-exposure): Systemic symptoms, rash on palms/soles.