Ceftriaxone – A plausible intervention for treating neurosyphilis?

Shuja, Syed Hasan; Naeem, Unaiza; Eqbal, Farea; Shuja, Muhammad Hamza

doi:10.1016/j.amsu.2022.104662

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…HIV infeksiyonu bulunan kişilerde eş zamanlı sifiliz de varsa, nörosifiliz gelişme riski daha fazladır (9) . HIV enfeksiyonu olan kişiler, HIV olmayan kişiler gibi tedavi edilmelidir (15) . Nörosifiliz birçok farklı klinik tablo ile ortaya çıkabilir.…”

Section: Discussionunclassified

Nörosi̇fi̇li̇z: Üç Olgu

Tüğdür,

Kaya,

Tol

et al. 2024

ANKEM Dergisi

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“Büyük taklitçi” sifiliz, Treponema pallidum’un neden olduğu multisistemik tutulum yapan bir hastalıktır. Nörosifiliz, yani sifilizin santral sinir sistemi (SSS) tutulumu genellikle sekonder ve tersiyer evrelerinde görülmekle birlikte her evrede karşımıza çıkabilir. Artan sifiliz olgu sayılarına paralel olarak primer enfeksiyondan 4-10 yıl sonra tedavi edilmeyen veya yetersiz tedavi gören olgularda nörosifiliz riski de artmıştır. Bu nedenle nörolojik ve psikiyatrik bozuklukların ayırıcı tanısında akılda tutulması gereken bir hastalıktır. Nörolojik tutulumda motor ve duyusal etkilenme, oftalmik ve işitsel semptomlar, kranial sinir paralizileri, menenjit semptom ve bulguları görülebilir. Hastalığa bağlı oküler bulgular SSS tutulumunun önemli belirteçlerindendir. En sık görülen psikiyatrik bozukluklar ise demans, depresyon ve grandiyozitedir. Burada kliniğimizde nadir olarak karşılaştığımız ancak artan sayılarla birlikte 2023 yılında takip edilen, farklı nörolojik ve oküler bulgular ile başvurmuş olan üç nörosifiliz olgusu konuya dikkat çekmek amacı ile paylaşılmıştır.

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Section: Discussionunclassified

Nörosi̇fi̇li̇z: Üç Olgu

Tüğdür,

Kaya,

Tol

et al. 2024

ANKEM Dergisi

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“…Blood investigations which were done relatively early on the admission reported positive syphilis serology. Ceftraixone which is a beta lactam antibiotic has been widely researched as a substitute for penicillin therapy for syphilis and also has better penetration for CSF (3). Most studies have reported comparisons between penicillin therapy and ceftriaxone 2g daily treatment for 10 -14 days (3).…”

Section: Discussionmentioning

confidence: 99%

A peculiar case of neurosyphilis presenting with general paresis of the insane with concurrent untreated HIV infection

Perera,

Ranasinghe,

Wimalarathna

et al. 2024

Sri Lanka J. Psyc.

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General paresis of insane or dementia paralytica is a rare conventional manifestation of neurosyphilis. In the era of penicillin and HIV it is a challenge to observe and diagnose typical presentations of neurosyphilis.42-year-old single male presented with an acute behavioural disturbance with hearing voices in a background of rapidly progressing forgetfulness and functional deterioration to the extent of needing support for his activities of daily living with urine incontinence for nine months duration. His beha-vioural change had first started with distressing insomnia leading to consumption of alcohol 30 units a day. Gradually displayed disorganised and dis-inhibited behaviour with some overactivity and was treated as a mood disorder with poor response and rapid deterioration of functioning.Investigations revealed marked impairment of frontal lobe and dominant parietal lobe functions in extended cognitive assessment. Blood investigations revealed normocytic normochromic anaemia with raised inflammatory markers: CRP, ESR, CPK with normal thyroid function. Syphilis serology was positive. Subsequently the examination carried out by an eye surgeon detected ocular syphilis. CSF analysis was negative for syphilis and the changes were most likely related to the untreated HIV infection with a CD4 count of 104 cells/μL. Neuroimaging showed generalized cortical atrophy with enlarged ventricles. He was treated for neurosyphilis as well as and treatment for HIV was initiated, but there was minimal improvement.Conclusions: Neurosyphilis remains as an important aetiology to be considered in rapidly progressing dementia in young patients. Comorbid HIV infection worsens the severity and prognosis.

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“…A course of intravenous aqueous Penicillin G ( Table 1 ) is recommended for neurosyphilis [86] , [87] . An effective alternative is intravenous ceftriaxone [88] , [89] , [90] . More than a 4-fold reduction in the non-treponemal test titer indicated successful treatment.…”

Section: Management Of Specific Infection-related Movement Disordersmentioning

confidence: 99%