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Author Topic: syphillis - lumbar puncture?  (Read 848 times)

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Offline aliveinla

  • Member
  • Posts: 247
syphillis - lumbar puncture?
« on: January 23, 2010, 12:36:40 PM »
Got a call from ID doc last Thursday telling me my syphilis is 1:32. It has been 1:2 for the past 2 years. He suggested me to get lumbar puncture to have my spinal fluid checked. I am really scared of this. After a day's google research, I found two sides of opinions: 1) for all poz, if syph 1:32 or greater, LP is suggested; 2) even LP is done, it's only to decide whether the germ has gone to the central nerve, so the patient will be treated with penciline anyway, unless the patient has nerve symptom, no need for LP.

I have no symptom, and I know it's a new infection -- should have been careful... I tend to believe argument #2 and I think my doctor was just trying to cover all the bases and be safe.

I went to doctor right away and got one shot of penciline. It should kill all the germs if it's a new infection, which I believe it's true. -- have been doing safe sex for the past years, only lapsed starting August 09 with about 3 guys.

Anyone had real experience of LP or HIV + Syphilis that can share with me will be greatly appreciated.
« Last Edit: January 23, 2010, 12:41:13 PM by aliveinla »
4/24/07: Last tested Neg
1/22/08: First tested Poz
1/30/08: CD4 393; 28%; VL: 44k
3/18/08: CD4 218; 26%; VL: 222K
4/24/08: CD4 402; 26%; VL: lab forgot
7/22/08: CD4 405; 25%; VL: 6,780
10/15/08: CD4 340, 26%; VL: N/A
2/4/09: CD4 394, 26%; VL: N/A
Jun 09: CD4 300, 25%; VL: 4000
Oct 09: CD4 324, 23%, VL: 10K
11/22/09: started Atripla
11/20/11: CD4 405; VL: UD

Offline redhotmuslbear

  • Member
  • Posts: 605
  • A genuine certified freak of nature, and a hot one
Re: syphillis - lumbar puncture?
« Reply #1 on: January 23, 2010, 12:49:07 PM »
While I have had several LPs for CSF studies related to hydrocephalus, not syphilis, I can appreciate the doctor's concern, as I have also been through several syphilis scares with friends and friends of friends recently.  The doc is concerned about syphilis attaching to your nervous system, a marker of tertiary syphilis that could also involve major organs.  Have you had symptoms of secondary syphilis, e.g. rashes, particularly on the soles and palms, or warty patches on skin folds?

An LP is nothing to be worried about.  Just make certain to stay horizontal and limit physical activity for a day afterwards.  My ex had an LP in relation to a possible stroke a few years ago while we were on vacation, and he didn't take a day to slow down afterwards, then suffered with severe headaches for days.
"The real problem is not whether machines think but whether men do." - BF Skinner
12-31-09   222wks VL  2430 CD4 690 (37%)
09-30-09   208wks VL  2050  CD4 925 (42%)
06-25-08   143wks VL  1359  CD4 668 (32%)  CD8 885
02-11-08   123wks off meds:  VL 1364 CD4 892(40%/0.99 ratio)
10-19-07   112wks off meds:   VL 292  CD4 857(37%/0.85 ratio)

One copy of delta-32 for f*****d up CCR5 receptors, and an HLA B44+ allele for "CD8-mediated immunity"... beteer than winning Powerball, almost!

Offline BlueMoon

  • Member
  • Posts: 665
  • Calling from the Fun House
Re: syphillis - lumbar puncture?
« Reply #2 on: January 23, 2010, 01:08:19 PM »
I had a lumbar puncture a couple of months ago, for the same reason your doctor is suggesting it.  I also felt that mine was a recent new infection, but didn't want to risk being wrong.  The procedure was easy with no complication.  The result was good and I took the regular treatment.

Which treatment, by the way, is a series of three shots one week apart, for HIV+ patients.  I'm surprised your doctor did only one.
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline aztecan

  • Member
  • Posts: 5,394
  • 29 years positive, 57 years a pain in the butt
Re: syphillis - lumbar puncture?
« Reply #3 on: January 23, 2010, 01:15:57 PM »
Hey there,

Actually, the two sides you mention in your post are one in the same.

The lumbar puncture is indeed a test needed to see if the syphilis organism has already invaded the fluid surrounding the brain and central nervous system. I had a lengthy discussion about this very subject with my doctor.

Because you are HIV positive, syphilis can progress much more rapidly than in someone who is HIV negative.

This is nothing to ignore and cannot be treated as easily as in those who are HIV negative.

The result is, if syphilis is detected in the spinal fluid, you would most likely need more than a simple shot of penicillin in the butt.

Someone who is HIV positive and whose lumbar puncture results indicate syphilis in the central nervous system may require hospitalization for a week during which the person is administered IV antibiotics.

I went through this with someone not too long ago.

While lumbar punctures are not fun, in this case, they are necessary.

I had two lumbar punctures when I was younger and had developed viral meningitis. It was when my first doctor believes I was seroconverting, but that is another story.

Keep us posted on how things go.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline aliveinla

  • Member
  • Posts: 247
Re: syphillis - lumbar puncture?
« Reply #4 on: January 23, 2010, 01:24:56 PM »
good catch. my doc suggested 3, but since I was going out of the country on 1/30 for a month, I had time to get only 2, 2 is nothing better than 1 accordling to my doc, so I made the suggestion of only getting one--it's standard for new infections within a year. 3 is for more than a year, doc said. My last blood work was 3 months ago so for sure it's new infection, i believe...

So your example is: LP was done as a precaution and there is no germ in nerves. I draw the conclusion that i don't want to do it for the slight chance it might in my nerve. I think i will wait for 3 months to see my new blood test. Getting a needle so deep and lie down for a day is just too scary. :-(

I had a lumbar puncture a couple of months ago, for the same reason your doctor is suggesting it.  I also felt that mine was a recent new infection, but didn't want to risk being wrong.  The procedure was easy with no complication.  The result was good and I took the regular treatment.

Which treatment, by the way, is a series of three shots one week apart, for HIV+ patients.  I'm surprised your doctor did only one.
« Last Edit: January 23, 2010, 01:28:16 PM by aliveinla »
4/24/07: Last tested Neg
1/22/08: First tested Poz
1/30/08: CD4 393; 28%; VL: 44k
3/18/08: CD4 218; 26%; VL: 222K
4/24/08: CD4 402; 26%; VL: lab forgot
7/22/08: CD4 405; 25%; VL: 6,780
10/15/08: CD4 340, 26%; VL: N/A
2/4/09: CD4 394, 26%; VL: N/A
Jun 09: CD4 300, 25%; VL: 4000
Oct 09: CD4 324, 23%, VL: 10K
11/22/09: started Atripla
11/20/11: CD4 405; VL: UD

Offline aliveinla

  • Member
  • Posts: 247
Re: syphillis - lumbar puncture?
« Reply #5 on: January 23, 2010, 01:32:03 PM »
Had rash on 11/21/09, and I actually posted the question on this board, thinking it might be shingles. One poster actually suspected syphilis. It pushed me to start HIV meds. Rash was all over the body but suprisingly not on sole and palms, all on my body that can be covered by clothes so I actually went to work the next day. Rash went away in 2 days.

Have you had symptoms of secondary syphilis, e.g. rashes, particularly on the soles and palms, or warty patches on skin folds?

An LP is nothing to be worried about.  Just make certain to stay horizontal and limit physical activity for a day afterwards.  My ex had an LP in relation to a possible stroke a few years ago while we were on vacation, and he didn't take a day to slow down afterwards, then suffered with severe headaches for days.
4/24/07: Last tested Neg
1/22/08: First tested Poz
1/30/08: CD4 393; 28%; VL: 44k
3/18/08: CD4 218; 26%; VL: 222K
4/24/08: CD4 402; 26%; VL: lab forgot
7/22/08: CD4 405; 25%; VL: 6,780
10/15/08: CD4 340, 26%; VL: N/A
2/4/09: CD4 394, 26%; VL: N/A
Jun 09: CD4 300, 25%; VL: 4000
Oct 09: CD4 324, 23%, VL: 10K
11/22/09: started Atripla
11/20/11: CD4 405; VL: UD

Offline aliveinla

  • Member
  • Posts: 247
Re: syphillis - lumbar puncture?
« Reply #6 on: January 23, 2010, 01:34:30 PM »
Yeah, I understand that. still scared though. No symptom on my nerves. Doc actually tested my ears, eyes, and eyebrow movements, found nothing wrong.

The result is, if syphilis is detected in the spinal fluid, you would most likely need more than a simple shot of penicillin in the butt.

Someone who is HIV positive and whose lumbar puncture results indicate syphilis in the central nervous system may require hospitalization for a week during which the person is administered IV antibiotics.

4/24/07: Last tested Neg
1/22/08: First tested Poz
1/30/08: CD4 393; 28%; VL: 44k
3/18/08: CD4 218; 26%; VL: 222K
4/24/08: CD4 402; 26%; VL: lab forgot
7/22/08: CD4 405; 25%; VL: 6,780
10/15/08: CD4 340, 26%; VL: N/A
2/4/09: CD4 394, 26%; VL: N/A
Jun 09: CD4 300, 25%; VL: 4000
Oct 09: CD4 324, 23%, VL: 10K
11/22/09: started Atripla
11/20/11: CD4 405; VL: UD

 


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