Tabes Dorsalis Health Article

Clinical trials

There is no trial open for tabes dorsalis, but there is an ongoing phase III multicenter randomized trial as of early 2004 funded by the National Institute of Allergy and Infectious Diseases (NIAID) for assessing the antibiotic Azithromycin given orally in treatment of primary, secondary or early latent syphilis. The NIAID and the National Institute of Neurological Diseases and Stroke (NINDS) are carrying out research to develop a non-invasive test for detecting syphilis and to develop a vaccine. The genome of Treponema pallidum has been sequenced through NIAID-funded research. This is a wealth of information that will hopefully lead to clues to better diagnose, treat and vaccinate against syphilis.

Prognosis

Tabes dorsalis is a chronic, annoying and incapacitating disease but is per se seldom fatal. If tabes dorsalis is diagnosed in its very early stages, fairly good recovery is possible. Pain is quite bothersome and has a serious impact on quality of life. Ataxia, dementia and blindness are incapacitating. Death usually occurs due to rupture of enlarged blood vessels and damage to heart valves, which occur as a part of tertiary syphilis. Rarely, a urinary infection will lead to sepsis and death.

Special concerns

Tabes dorsalis can affect thinking and memory and all patients must have neuropsychological testing for dementia. They will need to get legal advice for estate and financial planning and their wishes for future medical care.

BOOKS

Aminoff, Michael J., ed. Neurology and General Medicine, 3rd ed. New York: Churchill Livingstone, 2001.

Rowland, Lewis P., ed. Merritt's Neurology, 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2000.

Victor, Maurice, and Allan H. Ropper, eds. Principles of Neurology, 7th ed. New York: McGraw-Hill, 2001.

PERIODICALS

Birnbaum, N. R., R. H. Goldschmidt, and W. O. Buffet. "Resolving the Common Clinical Dilemmas of Syphilis." American Family Physician 59 (April 1999): 2233–2240.

Estanislao, L. B, and A. R. Pachner. "Spirochetal Infection of the Nervous System." Neurologic Clinics 17 (November 1999): 783–800.

Golden, R. M., M. M. Christina, and K. K. Holmes. "Update on Syphilis: Resurgence of an Old Problem." Journal of American Medical Association 290 (September 2003): 1510–1514.

WEBSITES

Clinical Trials Website. <http://www.clinicaltrials.gov/>.

ORGANIZATIONS

Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA 30333. (800) 232-3228. <http://www.cdc.gov>.

National Institute of Allergy and Infectious Diseases. 31 Center Drive, MSC 2520, Bethesda, MD 20892-2520. (301) 496-5717. <http://www.niaid.nih.gov>.

Chitra Venkatasubramanian, MBBS, MD