Syphilis evaluation

Psychotic Disorder Due to Generai Medical Condition. Certain medical illnesses occasionally present with symptoms of paranoid delnsions or hallucinations that resemble schizophrenia (Table 4.4). When these illnesses are snccessfully treated, fnll resolntion of the psychotic symptoms invariably occnrs. All patients presenting with new-onset psychosis shonld nndergo a thorongh medical evaluation including a physical exam, family and personal medical history, and laboratory stndies inclnding electrolytes, thyroid function tests, syphilis screen, vitamin B12 and folate levels, and a CT or MRI brain scan. A lumbar puncture (spinal tap) and electroencephalogram are sometimes also warranted. 

Evaluate all patients with gonorrhea for syphilis (see Precautions). P.857... 

Inspection of the posterior pole may be hindered by vitreous debris however, it is vitally important to evaluate for CME, a primary cause of visual deficit. Another notable finding in the posterior pole is papillitis, which may occur in a variety of etiologies such as syphilis, herpetic infection, and sympathetic ophthalmia. Chronic long-term complications involving the fundus may include choroidal neovascularization, chorioretinal scarring, epiretinal membrane formation, neovascularization, and retinal detachment. 

Hoang MP, High WA, Molberg KH. Secondary syphilis A histologic and immunohistochemical evaluation. J Cutan Pathol. 2004 31 595-599. 

Laboratory evaluation Recommended tests include TB skin test, screening for syphilis, hepatitis B, HIV, and recent drug use. Other recommendations include complete blood count (CBC),... 

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