![]() ![]() The US CDC data estimates that 5% of MSM with syphilis are also infected with HIV. There is a high rate of co-infection with HIV in those MSM patients who have contracted syphilis. This may be due to the fact that syphilis is more common in MSM, many of whom concurrently also have HIV, or it could reflect two separate groups with increased susceptibility. ![]() From 2000 to 2016, the rise in reported syphilis cases is primarily due to increased cases in the men who have sex with men population. The CDC acknowledges, however, that the disease is likely under-reported. According to the CDC: there were 30,676 cases of late and late latent cases of neurosyphilis reported in the United States in 2016. However, in the modern era, the number of cases of primary and secondary syphilis have been increasing every year since 2001, and continue to rise. The exam finding of Argyll Robertson pupils has been rare in the developed world since the advent of penicillin in the 1940s. The exact pathophysiology leading to the AR pupil, however, remains unknown. Neurosyphilis occurs due to an invasion of the cerebrospinal fluid (CSF) by the spirochete which likely occurs soon after the initial acquisition of the disease. EtiologyĪrgyll Robertson pupil is found in late-stage syphilis, a disease caused by the spirochete Treponema pallidum. Douglas Argyll Robertson in the mid-1860s. Argyll Robertson (AR) pupil was first described by Scottish ophthalmologist and surgeon, Dr. This finding is highly specific for late-stage syphilis.
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