The Management of Syphilis in Elderly Persons
Syphilis is one of the most serious of infectious diseases and each year late visceral lesions of the disease are responsible for the deaths of many individuals. Syphilis also has a high morbidity rate; consequently, the economic losses which are directly or indirectly traceable to this infection are appalling. This disease may simulate almost any condition and because of its protean manifestations, it is necessary that the physician should be familiar not only with its usual manifestations but that he should consider the possible presence of syphilis in the differential diagnosis of all chronic ailments. It has been estimated that approximately ten per cent of the adult population is infected with syphilis; therefore, every physician, whether he is a general practitioner or whether his practice is limited, is certain to be consulted by persons who present diagnostic and therapeutic problems caused by this disease.
Most syphilitics become infected in the second or third decade of life; therefore, the majority of elderly individuals who are now consulting the physician with symptoms and findings related to this infection contracted the disease before the arsphenamines and bismuth were used in treatment as extensively as they are now. Consequently, these individuals received little or no treatment in the early stages of their disease. Furthermore, the subsequent treatment which they received frequently was inadequate as compared with the present day standards of antisyphilitic therapy. Unless some means can be found to keep the young individual with acute syphilis under supervision long enough for the administration. . .