Yes, Virginia, There Is A Neurosyphilis
Back in 2nd year of med school, I thought learning about tertiary syphilis was rather silly. I figured people would definitely get treated once they had a chancre or any signs of secondary syphilis. (Speaking about US-only right now.) Turns out patients don’t read the textbooks, and don’t live in my little imaginary medical bubble world. Life always comes back and bites you on the ass.
About two months ago, I open up a chart and see: “Patient here for lab results positive for neurosyphilis.”
Graham’s law: The disease you don’t study, or decide that you’ll read about tomorrow is the disease a patient will come in with today. It’s happened to me so many times I’ve lost count. Always makes me read that one extra chapter, ’cause I figure I’ll get burned if I don’t.
I hear you. I’ve seen one case of neurosyphilis, during my 3rd year of med school, and I, too, thought I’d never see it. You’re right that most get treated earlier…those that go to their doctor, comply with their treatment, and have doctors that recognize the chancre/rash/whatever.
I guess this is more common than I thought. We had a older patient who was getting a complete workup for neuro changes and came up syphilis positive, no one suspected it, really, and he’s been married for 30+ years. Huge surprise to his wife.
Obviously you guys haven’t been to grady hospital in Atlanta. I have seen neurosyphilis at least 4 times and expect to see it a couple more within the next few months.
Maybe it’s a southern thing :)