REVIEW: Neurosyphilis: A Historical Perspective and Review

Abstract

Treponema pallidum subspecies pallidum, the causative agent of syphilis, disseminates to the central nervous system within days after exposure. Clinical manifestations can occur during any stage of the infection, and include asymptomatic neurosyphilis, acute meningeal syphilis, meningovascular syphilis, paretic neurosyphilis, and tabetic neurosyphilis. The majority of cases are reported in HIV-infected patients but the epidemiology of modern neurosyphilis is not well defined because of the paucity of population-based data. Decreasing reports of late neurosyphilis have been countered with increasing reports of early neurologic involvement. This review summarizes the clinical manifestations, diagnosis, and therapy of neurosyphilis, focusing on areas of continued controversy, and highlighting several important questions that remain unanswered. Since 2000, the rates of syphilis continue to increase. Given the effectiveness of penicillin therapy, these trends suggest a failure of prevention. Regrettably, rather than become an infection of historical significance, syphilis in the era of HIV continues to challenge researchers and clinicians.

Cerebrospinal fluid analysis in infectious diseases of the nervous system: when to ask, what to ask, what to expect

“…Neurosyphilis CSF analysis is the preferred method for diagnosing neurosyphilis (NS) 13 . The prevalence of NS has been increasing over recent decades, mainly as a comorbidity with AIDS 14,15,16 .…”

Nörosifiliz: Farklı Prezantasyonları

“…Patients found to be serologically positive without any neruologic symptoms are defined as neurosyphilis (6). Our third case may be included in this group that requires large serial studies, with reservations.…”

Serologic Response to Treatment in Syphilis

“…According to the diagnostic criteria, neurosyphilis can be defined in two categories, confirmed and presumptive, both can occur at any stage of syphilis. Confirmed neurosyphilis presents reactive CSF VDRL, while presumptive neurosyphilis is defined when patients present clinical signs or symptoms consistent with syphilis without an alternate diagnosis to account for these, non reactive CSF VDRL and CSF pleocytosis or elevated protein (Ghanem, 2010). A positive VDRL results establishes a diagnosis of neurosyphilis, but negative VDRL does not exclude it.…”