Final answer:
A patient with syphilis presenting with headaches and blurred vision needs an assessment for neurosyphilis. This includes a lumbar puncture for VDRL-CSF testing and treatment with intravenous penicillin G or desensitization if allergic.
Step-by-step explanation:
If a patient with syphilis is experiencing headaches and blurred vision, the next step would typically involve evaluating the patient for neurosyphilis, which is a progression of syphilis infection to the nervous system. This condition can occur at any stage of syphilis but is particularly associated with the tertiary stage. Symptoms such as headache, blurred vision, paralysis, and dementia, as seen in neurosyphilis, require prompt medical attention.
The recommended diagnostics in addition to blood tests for such on a presentation includes a lumbar puncture to analyze cerebrospinal fluid (CSF) using the VDRL-CSF test or other appropriate CSF tests. This is because routine serologic tests for syphilis, such as the RPR or VDRL tests, which are used for screening, may not detect neuroinvasive disease. Therefore, a CSF examination is crucial for diagnosing neurosyphilis and guiding subsequent treatment.
Treatment typically involves intravenous penicillin G or other suitable antibiotics if the patient is allergic to penicillin. Desensitization to penicillin may be required before treatment can proceed.