HIV and ID Observations

January 13th, 2020

Diagnostic Tests for Syphilis Continue to Perplex Even the Experts: An Unanswerable Question in Infectious Diseases

Here’s a tricky clinical scenario: An elderly person with cognitive decline or some other non-specific neurologic symptom sees a clinician. Clinician sends a syphilis screen with a T. pallidum enzyme immunoassay (TP-EIA), which returns positive. Lab runs a confirmatory test — a T. pallidum particle agglutination test (TP-PA), or similar, which also returns positive. The lab […]

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June 18th, 2012

ID Learning Unit — Serologic Tests for Syphilis

Diagnosing syphilis is tricky for lots of reasons, including: The protean disease manifestations, many of which were best described in older medical literature — and hence not known to people who don’t read words on paper (vs a screen) very often. You can’t visualize the bug (Treponema pallidum), unless you happen to have a darkfield microscope […]

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December 6th, 2010

Tough Diagnoses: Neurosyphilis, Then and Now

During Thanksgiving, my brother-in-law — who is a professional musician and also a passionate history buff — gave me a scholarly paper to review on the strange death of the famous American explorer Meriwether Lewis, of “Lewis and Clark” fame. The bottom line?  Lewis may well have had neurosyphilis — at least that’s the premise of the […]

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