The presence of spirochetes in late seronegative syphilis

Unmasking AIDS: chemical immunosuppression and seronegative syphilis

In both African AIDS populations and homosexual populations outside of Africa, a high incidence of syphilis and multiple exposures to infectious diseases results in frequent, often abusive use of antibiotics. Epidemiological evidence exists for chemical immunosuppression resulting from antibiotics and other prescribed and recreational drugs prior to the current AIDS crisis. Analysis and review of literature is given on the effects of subcurative doses of antibiotics masking and distorting the expression of secondary and tertiary syphilis. A high incidence of seronegative syphilis is found in Africa and compares with Western reports of seronegativity and persistence of treponemes despite adequate antibiotic therapies. Late latent and tertiary syphilis produce symptoms and immunosuppression comparable to that seen in the current AIDS crisis. Screening procedures instituted for a group of gay men with AIDS and AIDS related conditions is revealing evidence of chemically immunosuppressed syphilis as a factor in AIDS. Key words: AIDS, immunosuppression, syphilis, chemical immunosuppression, seronegativity, immunosuppressive sera, etiology of AIDS.

Neurosyphilis revisited. A contemporary wolf in sheep's clothing?

Neurosyphilis has become an uncommon clinical problem, for primary and secondary infections are usually recognised and treated early and successfully. However, patients occasionally receive no treatment for their acute infections--usually because they fail to seek advice--or may receive inadequate therapy when prescribed oral penicillin for other infections. The natural course of the disease is thus influenced, but the syphilis is not cured. Variegated clinical presentations of late disease arise and may make objective diagnosis difficult, especially when this occurs in a clinical setting where neurosyphilis may not be entertained in the initial diagnostic deliberations. Details of three such patients, seen during the last five years in the Aberdeen hospitals, are described--and highlight the range and diversity of clinical presentations which may occur, and typify the problem of making a firm diagnosis while the condition is still potentially curable.

Electronystagmography in congenital and acquired syphilitic otitis

This study is an analysis of the electronystagmogram (ENG) changes in 17 patients with luetic vestibular disease with early and late acquired syphilis and congenital syphilis. Vestibular disturbances occurred in 80% of patients with luetic otitis. Among these patients the ENG gives signs of peripheral rather than central vestibular injury, and reduced vestibular response to caloric stimulation is the most common finding. Congenital syphilis patients have the greatest dysfunction, both in degree of ENG changes and incidence of bilaterality. We found no correlation between FTA-ABS levels and the amount of hearing impairment or vestibular injury. Treatment with penicillin and steroids had a beneficial subjective effect upon the symptoms of vertigo in over half the patients.