Syphilis presenting with headache and papilloedema

Cooper, Sarah; Razvi, Saif; Al-Ani, Ali; Winter, Andrew; Browne, Ben; Metcalfe, Richard

doi:10.1136/bcr.09.2008.1008

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…Unlike our case both of these patients displayed marked CSF pleocytosis 9 10. In addition to these cases, a retrospective study of 18 patients fulfilling the criteria of neurosyphilis, high ICP (50 cmH 2 0) was demonstrated in one patient.…”

Section: Discussioncontrasting

confidence: 41%

Syphilis mimicking idiopathic intracranial hypertension

Yri

Wegener²,

Jensen³

2011

Case Reports

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Section: Discussioncontrasting

confidence: 41%

Syphilis mimicking idiopathic intracranial hypertension

Yri

Wegener²,

Jensen³

2011

Case Reports

View full text Add to dashboard Cite

“…There was also 15% with ICP over 210 mmH2O in cerebrovascular neurosyphilis, and intracranial hypertension could also occur in general paresis [3]. In the current post-antibiotic era intracranial hypertension has decreased, but should not be disregarded as there still are a few confirmed reports [4,5].…”

Section: Discussionmentioning

confidence: 99%

Combined Salvage Treatments in a Case of Neurosyphilis

Chen,

Wang,

Wei

2023

Prog Med Sci

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Purpose: Visual loss and optic nerve head (ONH) edema are hallmarks in diagnosing optic neuritis, perineuritis, neuroretinitis and papillitis, but clinicians often disregard the role that intracranial hypertension could play in neurosyphilis. Methods: A case of syphilitic optic neuropathy with visual loss and bilateral ONH edema was presented, where the detailed diagnosis procedure of chronic intracranial hypertension and its treatment were described.

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“…Headaches in pregnancy present a unique diagnostic challenge fraught with cautiousness regarding imaging, pharmacotherapy, and diagnostic procedures due to the pregnancy state. Although most headaches in pregnancy are benign, infectious etiologies can be a rare source of a persistent headache but may be a consideration given the rising incidence of syphilis [ 13 , 14 ]. This is the first known case report of lytic lesions of the maternal calvarium due to a syphilis infection, with accompanying neuro and otosyphilis, that developed during the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Neurosyphilis with Calvaria Osteitis Presenting in Pregnancy

Newbery,

Henricks,

Vircks

et al. 2023

Case Reports in Obstetrics and Gynecology

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Background. The incidence of syphilis throughout the world is increasing. Rates in pregnancy are similarly rising, presenting risks of an untreated syphilis infection that can be detrimental to the mother and fetus. Although routine screening for syphilis infections is recommended at the initial prenatal visit, there is a lack of universal agreement on rescreening pregnant people and approximately 50% of syphilis cases are asymptomatic in the general population. Furthermore, some symptoms of syphilis can overlap with nonspecific pregnancy-related symptoms. Meanwhile, Treponema pallidum can spread to various maternal and fetoplacental tissues quickly after infection and occur at any stage of syphilis. Case. A 26-year-old gravida 5 para 2 presented with a new onset headache and visual and auditory changes at 23 weeks of gestation. A computerized tomography scan revealed numerous ill-defined lytic lesions throughout the calvarium, suspicious for syphilitic osteitis. She tested positive for syphilis antibodies with a rapid plasma reagin (RPR) titer of 1 : 32. Cerebrospinal fluid evaluation from a lumbar puncture resulted in reactive fluorescent treponemal antibody (FTA) testing. She was diagnosed with secondary syphilis with osteitis and neuro and otic components. She completed 14 days of intravenous aqueous crystalline penicillin G with additional benzathine penicillin G 2.4 million units intramuscular weekly for two weeks. There was no evidence of congenital syphilis on neonatal examination. Conclusion. Syphilitic osteitis and neuro, otic, or ocular syphilis infections occur rarely in the nonpregnant population, and therefore, little data in pregnancy is available to inform outcomes in these specific disease states. It is of paramount importance to complete appropriate syphilis screening, recognize symptoms, and consider utilizing rescreen protocols to ensure prompt infection identification and treatment. For neuro, otic, and ocular syphilis, aqueous crystalline penicillin G (as opposed to benzathine penicillin G) is required to achieve treponemicidal concentrations in those physiologic compartments. There is no agreement as to the appropriate treatment regimen for the rare finding of syphilitic osteitis.

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Syphilis presenting with headache and papilloedema

Cited by 7 publications

References 6 publications

Syphilis mimicking idiopathic intracranial hypertension

Syphilis mimicking idiopathic intracranial hypertension

Combined Salvage Treatments in a Case of Neurosyphilis

A Rare Case of Neurosyphilis with Calvaria Osteitis Presenting in Pregnancy

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