NEUROSYPHILIS
WILLIAM H. TIMBERLAKE M. D.
Virulent spirochetes have been demonstrated to persist in the blood of untreated syphilitic rabbits for over 4 years and even in the face of negative serologic tests.
The treponema immobilization test, a specific test for treponema pallida, has been further confirmed. It has been used to identify false positive, nonspecific serologic test results. When false positive serologic tests persist more than 6 months serious diseases, particularly the collagen diseases, should be sought as the cause.
The danger of giving cortisone or ACTH to syphilitic patients who are not receiving antiluetic treatment is emphasized. Topical cortisone temporarily prevents ocular damage in interstitial keratitis. Cortisone does not prevent the Jarisch-Herxheimer reaction, which is probably of the delayed type of hypersensitivity reaction.
Penicillin is the effective therapy for neurosyphilis including optic atrophy. Penicillin reactions are decreasing.
When the cells and protein of the spinal fluid have been normal for 2 years, any progression of symptoms is probably due to other neurologic disease.
