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* another confusing one
 #136438  
  dolly123 - 11/07/06 20:56
 
  42. An 82-year-old man comes to the physician
because of a 3-day
history of low back pain that radiates to the right
leg. He also has had
a lesion over the right shin and weakness of the right
foot. He began
taking prednisone 2 weeks ago for acute bronchitis.
He has chronic
obstructive pulmonary disease, benign prostatic
hypertrophy, and glaucoma.
Examination shows numerous papular and vesicular
lesions over the right
anterior and posterior shin. There is weakness of
right knee flexion,
ankle dorsiflexion, plantar flexion, eversion, and
inversion; the right
ankle reflex is absent. Sensation to pinprick and
cold is decreased
over the right lower extremity. Which of the
following is the most
likely causal organism?



Varicella-zoster virus
or treponema pallidum?



since he is on immmunocomp, i'm thinking can it be a reactivation/flare up of neurosyphis

does it present this way?
 
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* Re:another confusing one
#548372
  ben - 11/07/06 22:51
 
  agree its Zoster for sure  
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* Re:another confusing one
#548394
  upsups - 11/07/06 23:07
 
  and how do u explain the neurological features in zoster  
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* Re:another confusing one
#548466
  docfoofoo - 11/08/06 00:22
 
  no this is neurosyphilis.....plus the patient is really old and that is the majority of the cases that see neurosyphilis in ......  
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* Re:another confusing one
#548609
  amala - 11/08/06 05:40
 
  i think
VZ virus
 
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