Inflammatory diseases affecting the spinal cord
Milosh Perovitch in Radiological Evaluation of the Spinal Cord, 2019
Neurosyphilis caused by Treponema pallidum provokes a variety of changes in the central nervous system described in detailed pathologic and clinical studies.59 Neurosyphilis has become much less frequent due to the effective therapy that limits the disease usually to the primary or secondary stage. Some involvement of the central nervous system can still be encountered occasionally in incompletely cured cases. Syphilitic meningomyelitis causes a rather characteristic panarteritis with subsequent thrombosis leading to the infarction and the syphilitic sclerosis of the spinal cord. In tabes dorsalis, the grey gliosis of the posterior columns of the spinal cord may cause visible changes of the cord’s shape and size and can be recognized as a more or less diffuse atrophic process.70, 99 In the early 1950s, we performed myelography in some cases of tabes dorsalis and found a considerably narrowed spinal cord in the thoracic area with adhesions localized mainly in the distal part of the thoracic spine.
Infections in a Modern Society
Keith Struthers in Clinical Microbiology, 2017
Neurological manifestations are an example of the presenting symptoms and entities to consider include: Aseptic meningitis is part of the acute HIV syndrome, with headache, fever, neck stiffness, nausea and vomiting. There may be neuropathies of cranial nerves V, VII, VIII. The CD4 count is >200 cells/μL, and CSF has the parameters of a viral meningitis.Cryptococcus meningitis and Toxoplasma encephalitis usually manifest at a CD4 count of <200 cells/μL. Fever, headache and confusion are present and in the case of toxoplasmosis, seizures can occur. With cryptococcal meningitis, the CSF protein is raised, glucose decreased, and the heavily capsulated yeast can often be seen on India ink staining. Progressive multifocal encephalopathy caused by the JC papovavirus and central nervous system (CNS) lymphoma manifest at this stage.Cytomegalovirus (CMV) encephalitis with the subtle presentations of confusion, apathy and withdrawal usually occurs with a CD4 count below 50 cells/μL.It should be noted that neurosyphilis can arise at any stage of infection.
Prevention, Screening, and Treatment of Sexually Transmitted Infections
James M. Rippe in Lifestyle Medicine, 2019
The clinical presentation of syphilis can be described according to its stage. Primary syphilis presents as a singular, painless lesion (ulcer or chancre) on the genitals or site of infection, after an incubation period of two to three weeks. Generally, this lesion heals spontaneously in about four to five weeks. The sore is usually firm, round, and painless. Secondary syphilis may be seen four to eight weeks later. Symptoms include a maculopapular rash on the palms and soles, mucocutaneous lesions, lymphadenopathy, and malaise. Symptoms again spontaneously improve in three to six weeks. Tertiary syphilis may involve cardiac, gummatous lesions, tabes dorsalis, and generalized paresis. Neurosyphilis can occur at any stage. Latent syphilis has no clinical manifestations but is detected by serologic testing.27
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.
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.
Neurosyphilis cerebrospinal fluid findings in patients with ocular syphilis
Published in Ocular Immunology and Inflammation, 2021
M. Bazewicz, S. Lhoir, D. Makhoul, A. Libois, S. Van den Wijngaert, L. Caspers, F. Willermain
Neurosyphilis classification was made following CDC 2015 criteria, which can be interpreted in two ways as it states that ‘neurosyphilis is highly unlikely with a negative CSF FTA-ABS test’ (in case of negative CSF VDRL but with abnormal CSF cell count and/or CSF protein).6 If ‘highly unlikely’, should be interpreted as a negative result, then in our study 8 out of 14 patients (57%) with ocular syphilis had neurosyphilis. However, ‘highly unlikely’ does not exclude neurosyphilis and can be interpreted as a positive result. In this case in 2 patients of the study, neurosyphilis could not be excluded. According to this interpretation, neurosyphilis can be present in 10 out of 14 patients (71%) with ocular syphilis. This concerned patients number 2 and 8, who despite negative CSF RPR and negative CSF TPHA, had elevated CSF WBC, normal or elevated CSF proteins and doubtful CSF chemiluminescence.
Related Knowledge Centers
- Antibiotic
- Antibody
- Central Nervous System
- Cerebrospinal Fluid
- Lumbar Puncture
- Meningitis
- Treponema Pallidum
- Syphilis
- HIV/AIDS
- Antigen