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Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
Syphilis is a multisystem illness with protean clinical manifestations. Infection of the CNS with the spirochete Treponema pallidum leads to neurosyphilis. Like other spirochete syndromes, syphilis is divided into discrete clinical stages with characteristic manifestations; however, neurosyphilis can occur during any phase of illness.
Uveitis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
If syphilis is the cause of the uveitis, it should be treated as a case of neurosyphilis and treated with IV benzylpenicillin or ceftriaxone for 14 days. It is important to give concurrent systemic corticosteroids to decrease the inflammation and prevent a Harisch–Herxheimer reaction. Neurosyphilis should be ruled out by lumbar puncture, and like with all cases of syphilis, further testing for presence of other sexually transmitted diseases including an HIV test is indicated.
Encephalitis and Its Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Two spirochetal infections commonly involve the nervous system – neurosyphilis (Treponema pallidum) and neuroborreliosis. Neuroborreliosis, or nervous system Lyme disease, is typically caused by Borreliella (formerly Borrelia) burgdorferi in North America, by the closely related organisms B. afzelii, B. garinii, and others in Eurasia. Both commonly cause meningitis quite early in infection. In both, the basilar meningitis can be accompanied by cranial neuropathies. Both may develop parenchymal nervous system involvement later in infection, although this appears to be far more common in neurosyphilis.
Thyroid gland involvement in secondary syphilis: a case report
Published in Acta Clinica Belgica, 2022
Thomas Strypens, Gudrun Alliet, Greet Roef, Linsey Winne
Clinical manifestations of syphilis are highly diverse, ranging from asymptomatic to symptomatic. The disease can be classified into different stages based on clinical history, typical clinical signs or symptoms and serological tests. The World Health Organization (WHO) divides the disease into early syphilis and late syphilis [3]. Early syphilis consists of primary syphilis (ulceration or chancre at the site of infection), secondary syphilis (skin rash, mucocutaneous lesions, lymphadenopathy) and early latent syphilis (defined as infection for less than 2 years with no clinical signs or symptoms and positive serology) [3]. Late syphilis consists of tertiary syphilis (cardiac injury, gummatous lesions, tabes dorsalis, and generalized paralysis) and late latent syphilis (defined as infection for two or more years with no clinical signs or symptoms and positive serology)[3]. Neurosyphilis can occur during any stage of the disease. Early neurological symptoms include cranial nerve damage, meningitis, stroke, altered mental status, auricular and ophthalmological abnormalities [3]. These neurological symptoms present themselves within the first months or years after the primary infection. Late neurological symptoms include tabes dorsalis and generalized palsy which occur 10–30 years after the first infection [3]. This classification can guide initial therapy and further follow-up regimen. If left untreated, spontaneous resolution of the symptoms can occur, and the patients can enter a latent state of the disease.
Central nervous system intravascular lymphoma leading to rapidly progressive dementia
Published in Baylor University Medical Center Proceedings, 2021
Christie G. Turin, Kevin Ting, Anthony Bradshaw, S. Richard Dunham, Karen Nunez-Wallace, Shital M. Patel, Priti Dangayach, Stephanie Holdener, Weei-Chin Lin
The initial laboratory evaluation was notable for mild transaminitis and negative hepatitis panel and serum HIV test. He was found to have a low positive rapid plasma reagin (1:4 titer) with positive serum treponemal antibody, high lactate dehydrogenase (638 U/L), elevated ferritin (2148 ng/mL), and elevated erythrocyte sedimentation rate (97 mm/hr). His cerebrospinal fluid was notable for 3/µL leukocytes, 11/µL red blood cells, glucose 56 mg/dL, protein 262 mg/dL, and reactive Venereal Disease Research Laboratory test (1:1 titer). Broad-spectrum antibiotics were replaced with intravenous benzathine penicillin G for presumed neurosyphilis; however, he continued to decline. Repeat cerebrospinal fluid analysis showed 10/µL leukocytes (92% lymphocytes), glucose 68 mg/dL, and protein 437 mg/dL. Cytology was negative.
Analysis of EEG Lemple–Ziv complexity and correlative aspects before and after treatment of anti-syphilis therapy for neurosyphilis
Published in Neurological Research, 2019
MJ Jiang, HJ Zhang, WR Li, WQ Wu, YM Huang, DM Xu, YY Qi, KY Qin, L Zhang, JL Zhang
Neurosyphilis is a chronic central nervous system disease caused by syphilitic spirulina infection. It can lead to lesions in the brain, meninges, cerebrovascular, spinal cord, etc. It was once considered to be the late stage of syphilis (stage III) [9]. However, later studies [10,11] showed that all stages of syphilis may cause damage to the central nervous system and become neurosyphilis. In the early stage of syphilis, it mainly invaded the skin and mucous membranes. Many patients did not receive treatment because they had no obvious clinical symptoms, resulting in their invasion of the central nervous system and cardiovascular system, and progress to neurosyphilis. The clinical manifestations of neurosyphilis are diverse and the symptoms are non-specific and cover almost all the symptoms and signs of various nervous system diseases. At present, atypical asymptomatic neurosyphilis is rare in clinical practice.