||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?
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?