Case #3 fifty-five year old retired Navy Master Chief is brought into the ER by

Question

Case #3 fifty-five year old retired Navy Master Chief is brought into the ER by his young girlfriend. She states that her boyfriend has had an increase in lapses of memory and he is "walking trauma. While you are talking to the girlfriend, the patient interjects and states that he has been experiencing a lot of numbness in his fingers and lower extremities. Physical examination is significant for ataxia and Argyll Robertson pupil. funny" despite no recent .Which laboratory test is used as a screening test for this condition? Which laboratory test is specific and will confirm the presence or absence of this condition? What procedure would you request be performed on this patient? For this condition, what would you expect to be the typical" results? What is the most likely diagnosis?

Explanation / Answer

From the above symptoms, we can conclude that the patient is suffering from Neurosyphilis. It is a bacterial infection of brain or spinal cord.

a. Nontreponemal test is used as a screening test for this condition. This test includes 3 types of specify tests- the rapid plasma reagin test, Venereal disease research laboratory(VDRL) test and toluidine red unheated serum test . These tests usually react with IgM and IgG antibodies.

b. VDRL test is the main test and in this blood is drawn from the vein in the crease of the elbow or the back of the hand. This sample is sent to laboratory and tested for antibodies produced as a result of syphilis.

c. The diagnosis is based on clinical presentations and CSF findings.CSF WBC count of 20 cells/ml or greater and a reactive CSF VDRL and a positive CSF intrathecal T pallidum antibody index values are viewed and diagnosed.

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