Neurosyphilis, or chronic heavy metal poisoning: Karen Blixen's lifelong disease

Article Abstract:

Twentieth century Dutch author Karen Blixen ingested heavy metals to treat syphilis that may have caused her enduring illness. Syphilis first appeared in the late 1400s and developed a reputation as an incurable scourge. Early treatments included oral mercury, arsenic, and bismuth preparations. These heavy metals damaged the nervous system and caused anemia, skin reactions, and abdominal pain that were attributed to the infection. Blixen acquired syphilis in 1914 and took mercury pills for one year, after which she developed mercurial intoxication. In 1915, her blood tested positive for syphilis and she was treated with arsphenamine (Salvarsan). During the subsequent 40 years, samples of Blixen's blood and cerebrospinal fluid yielded no evidence of syphilis. She experienced attacks of excruciating abdominal pain followed by vomiting and diarrhea that were diagnosed as a neurologic complication of syphilis called tabetic neurosyphilis. She was plagued by general symptoms, weakness, and weight loss until her death in 1962.

Health aspects, Drug therapy, Syphilis, Heavy metals, Heavy metal poisoning, Syphilis patients, Dinesen, Isak

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Resolution of serum and cerebrospinal fluid abnormalities after treatment of neurosyphilis: influence of concomitant human immunodeficiency virus infection

Article Abstract:

HIV-infected patients with syphilitic infections of the central nervous system may take longer to clear the organism from their system or may never clear it despite what is believed to be adequate treatment. The only way of ascertaining whether neurosyphilis has been cured is by a resolution of cerebrospinal fluid (CSF) abnormalities. Researchers periodically analyzed CSF samples from 22 neurosyphilis patients until abnormalities had resolved. Thirteen patients had HIV infections and nine did not. All received standard antibiotic treatment. Pretreatment analyses were similar in HIV and non-HIV groups. In general, the return to normal values was slower in HIV-infected patients, including three HIV-infected patients who took longer than six months. No non-HIV patient failed to recover, but one HIV-infected patient still had abnormal values two years later. Even excluding these four patients, HIV-infected patients recovered more slowly compared with non-HIV patients.

Care and treatment, Analysis, Complications and side effects, HIV infection, HIV infections, Cerebrospinal fluid

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Finding neurosyphilis without the Venereal Disease Research Laboratory test

Article Abstract:

A combination of standard laboratory tests may be used to determine whether a person has neurosyphilis without relying solely on the Venereal Disease Research Laboratory (VDRL) test. Researchers analyzed samples of blood, brain and spinal fluid from 73 syphilis patients and 51 patients with known neurosyphilis. The cerebrospinal fluid (CSF)-VDRL test found only 27% of neurosyphilis cases. A combination of lab tests was used to compute a score that found 87% of true positive and 94% of true negative neurosyphilis diagnoses. The tests used were CSF-FTA-ABS, serum FTA-ABS, CSF-TPHA, CSF cells, and serum TPHA.

Evaluation, Diagnosis, Diagnosis, Laboratory, Laboratory diagnosis

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