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Neurosyphilis is the infection of the central nervous system in a patient with syphilis. In the era of modern antibiotics , the majority of neurosyphilis cases have been reported in HIV-infected patients.
Meningeal syphilis (as known as syphilitic aseptic meningitis or meningeal neurosyphilis) is a chronic form of syphilis infection that affects the central nervous system. Treponema pallidum , a spirochate bacterium, is the main cause of syphilis, which spreads drastically throughout the body and can infect all its systems if not treated ...
For neurosyphilis, due to the poor penetration of benzathine penicillin into the central nervous system, those affected are given large doses of intravenous penicillin G for a minimum of 10 days. [ 3 ] [ 34 ] If a person is allergic to penicillin, ceftriaxone may be used or penicillin desensitization attempted. [ 3 ]
Tabes dorsalis is a late consequence of neurosyphilis, characterized by the slow degeneration (specifically, demyelination) of the neural tracts primarily in the dorsal root ganglia of the spinal cord (nerve root). These patients have lancinating nerve root pain which is aggravated by coughing, and features of sensory ataxia with ocular ...
The fluorescent treponemal antibody absorption (FTA-ABS) test is a diagnostic test for syphilis.Using antibodies specific for the Treponema pallidum species, such tests would be assumed to be more specific than non-treponemal testing such as VDRL but have been shown repeatedly to be sensitive but not specific for the diagnosis of neurosyphilis in cerebrospinal fluid (CSF).
Argyll Robertson pupils were named after Douglas Argyll Robertson (1837–1909), a Scottish ophthalmologist and surgeon who described the condition in the mid-1860s in the context of neurosyphilis. In the early 20th century, William John Adie described a second type of pupil that could "accommodate but not react".
General paresis, also known as general paralysis of the insane (GPI), paralytic dementia, or syphilitic paresis is a severe neuropsychiatric disorder, classified as an organic mental disorder, and is caused by late-stage syphilis and the chronic meningoencephalitis and cerebral atrophy that are associated with this late stage of the disease when left untreated.
Pleocytosis, raised CSF protein level and positive CSF serology suggest neurosyphilis. [31] CSF VDRL is 50-90% specific for neurosyphilis. [18] 60% of newborns with congenital syphilis also have neurosyphilis. [18] Non-treponemal titers should be monitored in the newborns every 2-3 months to ensure an adequate response to treatment. [18]