Neurosyphilis and its precursors

This week I had the amazing opportunity of visiting the Musee de Moulage! The museum houses a collection of different dermatological illnesses and diseases. As I walked across the museum, I was amazed by the intricate casts that delineated the different conditions doctors had come across during their career. While many of the casts were grotesque, I realized that they served an important role—educating future generations of dermatologists. The elaborate 3D sculptures of faces, limbs, bodies, and genitalia gave future doctors an ability to recognize rare, dangerous infections that patients might present with. While I was unfamiliar with most of the dermatological diseases presented in the museum one caught my eye: Syphilis.

Image 1: Entering the Musee de Moulage.

In class this week, interestingly, we were exploring a paper focused on a late stage of syphilis: Neurosyphilis. Seeing the impact of syphilis first hand, instead of in a paper, was captivating and allowed me to make a more meaningful connection to the topic. The fact that a disease could insidiously spread through a human body and cause a myriad of physiological and psychological symptoms was fascinating. While syphilis and Neurosyphilis still exist today, antibiotics have drastically changed its morphology and presentation. As a result, examining the disease in its unhampered, unwavering state was an opportunity to gaze into its powerful past.

Image result for syphilis lesions
Image 2: Physiological symptoms of syphilis.

When I went home, I began to think about how syphilis could impact the brain and lead to both physiological/psychological symptoms. After performing a literature search, I found that Neurosyphilis can clinically present through a variety of symptoms. An article by Drago et al., (2016) showed that clinical symptoms of  NS,  today,  are diverse. Further, it has been shown that the neurological/psychological symptoms of NS are dependent on where the spirochetes of syphilis invade in the brain. Due to the fact that symptoms of NS can overlap with those of other neurological diseases, it can be incredibly hard to diagnose NS.

This article helped me understand the various presentations of NS in the age of antibiotics, but the expedition to the museum helped me understand how the disease manifested before the application of antibiotics. The article, additionally, helped me classify the behavioral and physiological symptoms that accompanied the 3D casts present at the museum. The article also gave insight into how diseases and conditions like HIV/AIDS could expedite the presentation of these symptoms for the modern doctor. Ultimately, this experience was incredibly humbling as it allowed me to grasp what a disease could do without antibiotics preventing its progression.

Drago, F., Merlo, G., Ciccarese, G., Agnoletti, A. F., Cozzani, E., Rebora, A., & Parodi, A. (2016). Changes in neurosyphilis presentation: a survey on 286 patients. Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.13753

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