Dissecting Presidential Neurosyphilis Speculation

As the world tries to explain the decisions, mannerisms, and behavior of the new US president, several explanations have been proffered. One particularly interesting conjecture, made by infectious disease physician Steven Beutler, involves neurosyphilis.

Extrapolating from the president's statements to Howard Stern about his experiences trying to avoid sexually transmitted infections, Dr. Beutler raises the issue of neurosyphilis

Syphilis is a very common infectious disease that has a prolific and storied past in which it infected people of all walks of life, including many famous individuals. It has various stages that, if untreated, can progress. Neurosyphilis is a late stage manifestation of infection and can cause neuropsychiatric disturbances. In fact, syphilis status is often checked in those presenting with neuropsychiatric symptoms at an older age. 

While primary syphilis cases have been increasing in recent years, cases of neurosyphilis in general are rare in the non-HIV positive population. Syphilis is caused by a bacteria called Treponema pallidum and it is usually exquisitely sensitive to antibiotics of the penicillin class and it has been suggested that all the courses of amoxicillin and other medications given (appropriately and inappropriately for sore throats, bronchitis, other STIs, and the like have blunted the development of late stage syphilis in those incubating the infection. 

While neurosyphilis can definitely cause erratic behavior and psychiatric disturbances I do not believe, in this case, it is ultimately the underlying explanation for this phenomenon. But this type of speculation regarding presidents is not new.