Presentation
The 41-year-old homosexual patient presented with meningitis and hydrocephalus. His CD4+ and CD8+ T-lymphocyte counts per microliter were 60 and 71, respectively. [ncbi.nlm.nih.gov]
The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary). [icd.codes]
Syphilis: uncommon presentations in adults. Clin Dermatol 2005; 23 : 555–564. [nature.com]
Entire Body System
- Fever
A man with systemic lupus erythematosus receiving chronic steroid therapy presented with headache, fever and panophthalmitis. Cerebrospinal fluid analysis was consistent with syphilitic meningitis. [ncbi.nlm.nih.gov]
Symptoms of syphilitic meningitis may include: Changes in vision, such as blurred vision, decreased vision Fever Headache Mental status changes, including confusion, decreased attention span, and irritability Nausea and vomiting Stiff neck or shoulders [medlineplus.gov]
Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen [books.google.com]
The spectrum of JH reaction, other than fever, rashes, or fever with exacerbation of skin rashes, is shown in Table 1. The median time to development of JH reaction was 4 hours (interquartile range, 2–5 hours) for the 2 groups. [doi.org]
The principal symptoms and signs are those of increased intracranial pressure; fever is only low-grade or may be absent. [std-aid.com]
Neurologic
- Meningism
DRG Group #097-099 - Non-bacterial infect of nervous system except viral meningitis with MCC. DRG Group #097-099 - Non-bacterial infect of nervous system except viral meningitis with CC. [icd.codes]
Congenital syphilitic meningitis (disorder) tertiary syphilitic meningitis edit English syphilitic meningitis Human disease secondary syphilitic meningitis acute secondary syphilitic meningitis (disorder) acute syphilitic meningitis (secondary) secondary [wikidata.org]
This report examines simultaneous tuberculous and syphilitic meningitis in a patient with human immunodeficiency virus (HIV). The 41-year-old homosexual patient presented with meningitis and hydrocephalus. [ncbi.nlm.nih.gov]
- Headache
A man with systemic lupus erythematosus receiving chronic steroid therapy presented with headache, fever and panophthalmitis. Cerebrospinal fluid analysis was consistent with syphilitic meningitis. [ncbi.nlm.nih.gov]
Symptoms of syphilitic meningitis may include: Changes in vision, such as blurred vision, decreased vision Fever Headache Mental status changes, including confusion, decreased attention span, and irritability Nausea and vomiting Stiff neck or shoulders [medlineplus.gov]
Early chapters present differential diagnosis and management approaches to common overarching problems such as coma, headache, and elevated intracranial pressure, followed by chapters focusing on the evaluation and management of specific conditions including [books.google.com]
Other symptoms may include sore throat, headache, joint pain, fever, and patches of hair loss. [en.wikipedia.org]
Clinical symptoms: mental changes, progressing to dementia; headache 3. Tabes Dorsalis : a. Pathology: Inflammatory lesions involving meninges and vessels in subarachnoid space of dorsal nerve roots. [kobiljak.msu.edu]
- Confusion
The second case was a 55-year-old female with epilepsy, depression, behavioral disorder and confusion. The diagnosis of HIV infection was made after onset of the syphilitic meningitis. [ncbi.nlm.nih.gov]
Confusion and other mental changes may either improve or continue long-term after antibiotic treatment. Late-stage syphilis can cause nerve or heart damage. This can lead to disability and death. [medlineplus.gov]
Detection of Treponema pallidum succeed in the dark field microscope (non-specific, such as confusion with oral, non-pathogenic spirochetes) or specifically by PCR. [treponemapallidum.org]
[…] is common within a few months of primary infection symptoms of meningitis can occur at any time after the infection however, it usually appears within two years symptoms may include headache, stiff neck, cranial nerve palsies, convulsions, and mental confusion [en.wikipedia.org]
Hydrocephalus is a rare complication and confusion, delirium, and papilledema also may be seen in combination with the other symptoms and signs listed above. [cancertherapyadvisor.com]
- Myelopathy
The hyperintense signals on T2 weighted image are nonspecific and may be present in other forms of noncompressive myelopathies. [neurologyindia.com]
Human immunodeficiency virus, type 1 (HIV-1) infection can often lead to a number of neurological events including peripheral neuropathy, myopathy, vacuolar myelopathy; and cognitive, motor and behavior abnormalities. [books.google.de]
[…] subacute basal meningitis, a meningovascular syndrome of small deep cerebral and cranial nerve infarctions, chronic gummatous inflammation with focal intracranial mass lesions, chronic comportmental dementia of general paresis, and chronic sensory-ataxic myelopathy [doi.org]
[…] central nervous system caused by the spirochete Treponema pallidum. 2 The AIDS pandemia have brought neurosyphilis back to the center of attention in global health. 2 Its clinical presentation may include acute lymphatic meningitis, stroke, dementia and myelopathy [nature.com]
Tertiary syphilis occurs more than 5 years after the primary stage as space-occupying cerebral lesions from intracerebral gumma or myelopathy from tabes dorsalis. HIV co-infection has altered the natural history of syphilis [ 1 ]. [omicsonline.org]
- Personality Change
[…] sensorineural hearing loss, tinnitus, and vertigo due to involvement of inner ear structures 4,13 occurs months to years after infection 13 Late neurosyphilis general paresis (or general paralysis of the insane) characterized by dementia with marked personality [radiopaedia.org]
Prevention of syphilis includes avoiding contact of bodily fluids with an infected person. [en.wikipedia.org]
The symptoms appear from months to a decade after the primary infection and may include seizures, hemiplegia, insomnia, personality changes, and dementia. [ajnr.org]
A subacute encephalitic prodrome is present, with headaches, vertigo, insomnia, and psychological abnormalities (eg, personality change, emotional lability, insomnia, decreased memory), followed by a gradually progressive vascular syndrome. [emedicine.medscape.com]
There is progressive personality change, memory loss and confusion. Sometimes depression or hallucinations occur. Tabes dorsalis. This is another, late form of neurosyphilis, more common before antibiotic treatment. [patient.info]
Workup
Other Pathologies
- Gliosis
Pathology: Atrophy, loss of cortical neurons especially in frontal lobes, gliosis, proliferation of microglial cells (rod cells), perivascular lymphocytes and plasma cells. Spirochetes present in brain tissue. b. [kobiljak.msu.edu]
Pathologically, this type is characterized by a perivascular and meningeal chronic inflammatory reaction with meningeal fibrosis, granular ependymitis, degeneration of the cortical parenchyma (ie, atrophy, gliosis), and tissue invasion with spirochetes [emedicine.medscape.com]
Treatment
Pre-treatment (D–F) and post-treatment (G–I) coronal images demonstrate complete resolution at 7 months. [doi.org]
Treatment does not reverse existing damage. [medlineplus.gov]
The sooner the treatment is started, better is the outcome. If treatment is delayed or is lacking; it could develop into a serious medical issue with long-term neurological complications. [dovemed.com]
Prognosis
CD4 and CD45RO T cells in CSF are a useful complement in differentially diagnosing SM and TBM; it contributes to further understand the pathogenesis and prognosis of SM and TBM. © 2016 APMIS. Published by John Wiley & Sons Ltd. [ncbi.nlm.nih.gov]
Prognosis is generally good unless there are established non-reversible changes such as cerebral infarction or atrophy 1,10. Related articles: Infections of the central nervous system Promoted articles (advertising) [radiopaedia.org]
[…] symptoms resolve spontaneously, although the course of the disease continues unchanged Please find comprehensive information on regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]
Serological tests for cryptococcal antigen PROGNOSIS : Almost always fatal if it goes untreated (90% of patients die within one year). TREATMENT : 1. Amphotericin B injected I.V. and into the subarachnoid space. [atsu.edu]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiology Treponema bacteria (particularly during stages I/II) are highly contagious! Sexual contact with a partner who suffers from active syphilis will lead to infection in 30% of cases! [amboss.com]
Prevalence More common in the preantibiotic era and now most often seen in patients with HIV, with predominance of early neurosyphilis compared with late neurosyphilis Etiology and Pathophysiology T. pallidum, spirochete Meningeal and meningovascular [unboundmedicine.com]
MM 331-337; 586-588, ID 1132-1140 CHRONIC MENINGITIS NAMES OF DISEASE : Fungal meningitis Cryptococcosis Torulosis Tubercular meningitis Amoebic meningitis Syphilitic meningitis ETIOLOGICAL AGENTS : Cryptococcus neoformans (Serotypes A,B,C,D) Treponema [atsu.edu]
(Etiology) Syphilis is a contagious bacterial infection that is transmitted through sex with an affected individual. [dovemed.com]
Epidemiology
Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen [books.google.com]
The work includes considerable emphasis onthe epidemiology, psychological and psychiatric aspects of the disease complex. [books.google.de]
Each of these other conditions may have some unique epidemiologic, clinical, and laboratory features pointing to the correct diagnosis. [std-aid.com]
Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. Etiology Treponema bacteria (particularly during stages I/II) are highly contagious! [amboss.com]
Conclusions: This case series illustrates important features currently attributed to neurosyphilis, which remains an important disease in Neurology, especially in some epidemiological risk groups. Disclosure: Dr. Borges has nothing to disclose. Dr. [neurology.org]
Pathophysiology
These include the characteristic neuroimaging appearance of specific bacterial infections, the limitations of neuroimaging, the cerebrospinal fluid analysis, the pathogenesis and pathophysiology of bacterial CNS infections, the developments of specific [books.google.de]
References: [3] [4] Pathophysiology Clinical features Primary syphilis Primary lesion ( chancre ) Typically starts out as a solitary, raised papule (usually on the genitals) Evolves into painle ss, firm ulcer with indurated borde rs and smooth base Resolves [amboss.com]
Prevalence More common in the preantibiotic era and now most often seen in patients with HIV, with predominance of early neurosyphilis compared with late neurosyphilis Etiology and Pathophysiology T. pallidum, spirochete Meningeal and meningovascular [unboundmedicine.com]
The pathophysiology of syringomyelia in syphilitic spinal meningitis remains unclear. [nature.com]
New insights into the pathophysiology of the Jarisch-Herxheimer reaction. J Antimicrob Chemother 1992 ; 29: 613 Google Scholar | Crossref | Medline | ISI 74. Tucker, HA, Robinson, RCV. [doi.org]
Prevention
Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen [books.google.com]
There are vaccines to prevent some of the bacterial infections that cause meningitis. [icdlist.com]
Syphilitic meningitis can be life-threatening, but it’s preventable. Early diagnosis and treatment of syphilis can prevent this complication. It takes years, or even decades, for untreated syphilis to cause neurological disease. [healthline.com]
Vaccines are not yet available for the prevention of neonatal meningitis, but other prevention strategies are being promoted. [doi.org]