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Suggest Treatment For Neurosyphilis, Papiledema And A Brain Lesion
Question: Hi I'm currently being treated for neurosyphilis. My diagnosis was Neurosyphilis, Papiledema, and a brain lesion. My Dr thinks I contracted the infection within the last year based on my condition. I think I may have contracted syphilis on Nov 24th 2014. My question is my 2 week treatment with IV penicillin ends tomorrow and my vision in my right eye has improved only slightly since the beginning of treatment. Vision in the left eye appears unaffected. Do you think my vision will improve after the treatment is over? Very anxious over the minimal improvement.
Brief Answer:
If adequatly treated there is good prognosis of visual loss.
Detailed Answer:
Dear As the severity of this disease is related to total number of spirochetes(treponoma causing syphillis) in the body not the dose of penicillin given.Therefore after treatment the VDRL test should be repeated at one,three,six and 12 months.A persistant fall in VDRL titre after treatment provides essential evidence of an adequate response to therapy so the complete prognosis.
It is good sign that your vision improved after treatment. And complete recovery takes time,for that proper follow up after treatment is essential ,as aquired immunity develops three to six months after infection. This immunity is incomplete and re-exposure to syphillis can bring about asymptomatic re_infection. Therefore follow up with repeated VDRL test to check the spirochetes number in body is essential.
In my opinion, for neurosyphilis and papiloedema lumber puncture should be repeated every six months for two years. I am not sure if these options were discussed with you by your treating doctor. If not, I suggest discussing them. So proper follow up with your treating doctor is essential.
Hopefully my answer will be helpful for you.You may ask further if you have more questions to ask.
Regards,
Dr.Maheshwari
If adequatly treated there is good prognosis of visual loss.
Detailed Answer:
Dear As the severity of this disease is related to total number of spirochetes(treponoma causing syphillis) in the body not the dose of penicillin given.Therefore after treatment the VDRL test should be repeated at one,three,six and 12 months.A persistant fall in VDRL titre after treatment provides essential evidence of an adequate response to therapy so the complete prognosis.
It is good sign that your vision improved after treatment. And complete recovery takes time,for that proper follow up after treatment is essential ,as aquired immunity develops three to six months after infection. This immunity is incomplete and re-exposure to syphillis can bring about asymptomatic re_infection. Therefore follow up with repeated VDRL test to check the spirochetes number in body is essential.
In my opinion, for neurosyphilis and papiloedema lumber puncture should be repeated every six months for two years. I am not sure if these options were discussed with you by your treating doctor. If not, I suggest discussing them. So proper follow up with your treating doctor is essential.
Hopefully my answer will be helpful for you.You may ask further if you have more questions to ask.
Regards,
Dr.Maheshwari
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Above answer was peer-reviewed by :
Dr. Prasad
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