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Syphilitic Meningitis

Meningeal Neurosyphilis


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]
  • Syphilis: uncommon presentations in adults. Clin Dermatol 2005; 23 : 555–564.[nature.com]
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]
  • The principal symptoms and signs are those of increased intracranial pressure; fever is only low-grade or may be absent.[std-aid.com]
  • 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]
Pseudotumor
  • A report of two cases followed for 20 years. ( 2971679 ) Currie J.N....Lessell S. 1988 11 Syphilitic meningitis masquerading as pseudotumor cerebri. ( 3579655 ) Bakchine S....Bousser M.G. 1987 12 Acute syphilitic meningitis.[malacards.org]
Plethora
  • The emerging new fields of genomics andproteomics have begun to better define the host factors that permit active viral production in the brain as well as lead to a secretion of a plethora of inflammatory and cytotoxic factors that lead to neuronal injury[books.google.de]
Yawning
  • By Richard Klasco, M.D Photo Credit Ask Well Photo Credit Why Do We Yawn? Reading about yawning makes people yawn. You are probably yawning right now. By Roni Caryn Rabin Latest Search Latest Articles Search Articles 13843 results for sorted by[nytimes.com]
Behavior Disorder
  • 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]
Sexual Dysfunction
  • Dysfunction 1203 Chapter 104 Womens Sexual Dysfunction 1210 Chapter 105 Sexuality Education for Young People 1221 A CultureBound Sex Related Disorder in Indian Subcontinent 1225 Chapter 107 Clinical Services for Sexually Transmitted Infections and HIV[books.google.com]
Meningism
  • 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]
  • This is accompanied by nausea, headaches, and muscular stiffness (in the neck region).[dovemed.com]
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]
  • […] 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]
  • 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]
  • 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]
Neck Stiffness
  • […] patients are asymptomatic and will only have evidence of neurosyphilis in CSF analysis 1,4 occurs weeks to months after infection 3,4 acute syphilitic meningitis clinical features identical to those of a bacterial leptomeningitis, such as headache, neck[radiopaedia.org]
  • Syphilitic meningitis presents with the same CSF findings, as well as typical meningitic symptoms such as headache, fever, and neck stiffness. (7)(8)(5) Later neurologic manifestations of the tertiary phase include meningovascular syphilis, tabes dorsalis[emdocs.net]
Bulging Fontanelle
  • We report a neonate who presented at 60 hours of life w ith irritability, poor activity, seizures and bulging fontanel. He was confirmed to have acute syphilitic meningitis.[content.iospress.com]

Treatment

  • Acute syphilitic meningitis developed in a 36-year-old man three months after apparently successful treatment of secondary syphilis with doses of penicillin G benzathine recommended by the current Centers for Disease Control guidelines.[ncbi.nlm.nih.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]
  • Treatment does not reverse existing damage.[medlineplus.gov]

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]
  • […] 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]
  • Prognosis is generally good unless there are established non-reversible changes such as cerebral infarction or atrophy 1,10 .[radiopaedia.org]
  • 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) Syphilis is a contagious bacterial infection that is transmitted through sex with an affected individual.[dovemed.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]
  • 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]
  • Syphilis infection has also been linked to a specific pituitary inflammation, named granulomatous hypophysitis, in analogy to other granulomatous infectious etiologies [ 10 – 13 ].[bmcinfectdis.biomedcentral.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]
  • Each of these other conditions may have some unique epidemiologic, clinical, and laboratory features pointing to the correct diagnosis.[std-aid.com]
  • The work includes considerable emphasis onthe epidemiology, psychological and psychiatric aspects of the disease complex.[books.google.de]
  • We need continued evaluation of the epidemiology of the disease to identify appropriate targets for immunization or other preventive strategies.[doi.org]
  • 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]
Sex distribution
Age distribution

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]
  • The pathophysiology of syringomyelia in syphilitic spinal meningitis remains unclear.[nature.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]
  • 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]
  • 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]

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