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https://www.readbyqxmd.com/read/29329180/diplopia-an-overlooked-feature-in-patients-with-neurosyphilis-report-of-2-cases-and-literature-review
#1
Sarah Patricia Rolimpandoei, Xiaodong Sun, Xin Shi, Ryan Edrick Leman, Lixia Xie, Lingling Chen
Both neurosyphilis and diplopia are widely known medical terms. Nevertheless, low clinical awareness by the physician and the often-overlooked presentation of diplopia, make the combination of neurosyphilis and diplopia rarely observed. In this article, we report 2 neurosyphilitic patients presenting with diplopia and review 8 additional case reports of neurosyphilis with diplopia, with a total of 10 cases to be analyzed.
February 2018: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29260044/isolated-presumed-optic-nerve-gumma-a-rare-presentation-of-neurosyphilis
#2
Nailyn Rasool, James A Stefater, Dean Eliott, Dean M Cestari
Purpose: The incidence of syphilitic infections continues to rise and represents a major public health concern, particularly in patients co-infected with human immunodeficiency virus (HIV). The infection has a multitude of clinical presentations and is often referred to as the 'great imitator.' We present a rare case of an isolated presumed syphilitic optic nerve gumma and characterize it using newer imaging modalities. Observations: A 36-year-old HIV-positive man, compliant with treatment, presented with a five day history of decreased vision in the left eye...
June 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29229275/frequency-of-treponema-pallidum-invasion-into-cerebrospinal-fluid-in-primary-or-secondary-early-stage-syphilis
#3
Mao Hagihara, Yuka Yamagishi, Hideo Kato, Yuichi Shibata, Arufumi Shiota, Daisuke Sakanashi, Hiroyuki Suematsu, Hiroki Watanabe, Nobuhiro Asai, Yusuke Koizumi, Tatsuro Furui, Seiichiro Takahashi, Koji Izumi, Hiroshige Mikamo
Frequency of Treponema pallidum invasion into cerebrospinal fluid (CSF) has not been clear at this present. Since it is impossible to culture T. pallidum in vitro at this present, we need molecular based-approach to detect it in CSF. Additionally, neurosyphilis is usually a late sequela, however it might result in asymptomatic neurosyphilis even at primary or secondary syphilis. This study was to reveal the frequency of T. pallidum invasion into CSF especially at primary or secondary syphilis with polymerase chain reaction (PCR) test...
December 8, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29225977/double-morphology-tertiary-syphilis-and-acquired-immunodeficiency-syndrome-a-rare-association
#4
R M Ngwanya, B Kakande, N P Khumalo
Background: Human immunodeficiency virus (HIV) and Treponema pallidum coinfection is relatively common and accounts for about 25% of primary and secondary syphilis. Tertiary syphilis in HIV-uninfected and HIV-infected patients is vanishingly rare. This is most likely due to early treatment of cases of primary and secondary syphilis. There is rapid progression to tertiary syphilis in HIV-infected patients. Case Presentation: A 49-year-old woman diagnosed with HIV Type 1 infection and cluster of differentiation 4 (CD4) count of 482 presented with a four-week history of multiple crusted plaques, nodules, and ulcers on her face, arms, and abdomen...
2017: Case Reports in Dermatological Medicine
https://www.readbyqxmd.com/read/29199801/relevance-in-biology-and-mechanisms-of-immune-and-treatment-evasion-of-treponema-pallidum-a-review
#5
Francesco Drago, Sanja Javor, Aurora Parodi
INTRODUCTION: During syphilis a compelling fight is engaged between the host's humoral and cellular immune responses that work to eliminate the infection and Treponema pallidum (T. pallidum) that manages to evade eradication and cause chronic infection. Different mechanisms are utilized by treponemes to overcome immunological response. Although penicillin (BPG) proved to be effective in quelling the early manifestations of the disease and consequently its contagiousness, questions remain about its ability to prevent the late complications and to provide a microbiological eradication in vivo...
December 1, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29199527/diversity-in-clinical-manifestations-and-imaging-features-of-neurosyphilis-obstacles-to-the-diagnosis-and-treatment-report-of-3-cases
#6
Hui Liu, Zong-Bo Zhao, Nian-Xing You
OBJECTIVE: To explore the clinical manifestations and imaging features of neurosyphilis and to discuss the obstacles in the diagnosis and treatment of neurosyphilis. METHODS: We present this case study involving 3 cases of definite neurosyphilis, focusing on their clinical data. RESULTS: Case 1 is a patient with numb and weak left lower limb. Case 2 showed slow reaction and dementia behaviors including worse memory and the decrease of calculation and orientation ability in this patient...
December 2, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29197841/haemorrhagic-conversion-of-infectious-myelitis-in-an-immunocompromised-patient
#7
Michael Stephen Pohlen, Jonathan Sunwei Lin, Kevin Yuqi Wang, Mohammad Ghasemi-Rad, Christie M Lincoln
A 28-year-old man recently diagnosed with HIV (CD4 19 cells/mm3, viral load 3.6 million copies/mL, not on highly active antiretroviral therapy on initial diagnosis at outside hospital), disseminated histoplasmosis, shingles and syphilis presented with paraplegia developing over 3 days. Spine MRI demonstrated a longitudinally extensive cord lesion extending from C3 to the tip of the conus. Brain MRI was consistent with meningoencephalitis. Cerebrospinal fluid findings were notable for positive varicella zoster virus (VZV) and cytomegalovirus (CMV) PCRs as well as a Venereal Disease Research Laboratory titre of 1:2...
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29188351/-chronic-course-of-neurosyphilis
#8
S Krämer, D Clark, M Ziegenbein
No abstract text is available yet for this article.
November 29, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/29185547/role-of-mri-in-early-detection-of-stroke-secondary-to-neurosyphilis-in-an-elderly-patient-coinfected-with-hiv
#9
Aintzine Ruisánchez, Iñigo Vicente-Olabarria, Ines Escalza-Cortina, David Anguizola, Ines García-Gorostiaga, Marian Gomez-Beldarrain, Juan Carlos Garcia-Monco
No abstract text is available yet for this article.
April 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29169563/historical-reflections-on-neurosyphilis-based-on-the-1826-treatise-on-general-paralysis-in-demented-patients-by-louis-florentin-calmeil-1798-1895
#10
REVIEW
F Macia, Y Ardagna
General paralysis is a neurological symptom of tertiary syphilis that was first identified in asylums as paralytic madness. The enlightened discussion of 60 clinicopathological cases provided by Louis Florentin Calmeil in his 1826 treatise greatly improved our knowledge of general paralysis. However, Calmeil was unable to relate this symptom to syphilis, although the latter was quite widespread at that time. Following a detailed reanalysis of Calmeil's observations with special attention to his clinical and demographic data, we conclude that this eminent clinician was unable to define the cause of general paralysis because his early 19th century mind was still under the influence of traditional knowledge and moral prejudices...
November 20, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/29167762/lncrna-expression-in-cd4-t-cells-in-neurosyphilis-patients
#11
Li-Li Liu, Shao-Gang Zhu, Xiao-Yong Jiang, Jun Ren, Yong Lin, Ning-Ning Zhang, Man-Li Tong, Hui-Lin Zhang, Wei-Hong Zheng, Hua-Jun Fu, Hai-Juan Luo, Li-Rong Lin, Jiang-Hua Yan, Tian-Ci Yang
Recent studies have shown that several long noncoding RNAs (lncRNAs) are involved in regulating the immune response to cope with pathogenic invasion. To date, the roles of lncRNAs in the CD4+ T cell response to Treponema pallidum (T. pallidum) infection in neurosyphilis patients remain unknown. The mRNA and lncRNA expression profiles of CD4+ T cells that were isolated from neurosyphilis patients and healthy controls were analyzed by microarray. A total of 2258 lncRNAs and 1728 mRNAs were identified as over-expressed or under-expressed, respectively (fold change > 1...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/29133821/incidence-of-asymptomatic-neurosyphilis-in-serofast-chinese-syphilis-patients
#12
Sheng Nan Cai, Jing Long, Chen Chen, Gang Wan, Wen Hui Lun
More new diagnosed syphilis cases were reported in china, the incidence and relevant factors of asymptomatic neurosyphilis (ANS) in serofast syphilis patients were unclear. Clinical and laboratory data of 402 Human Immunodeficiency Virus (HIV) negative, serofast syphilis patients, who underwent lumbar puncture at the Peking University Ditan Teaching Hospital between September 2008 and August 2016, were collected. Incidence of ANS was verified and the relevant factors were further analyzed. According to the ANS criteria, 139 (34...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29117430/biological-false-positive-venereal-disease-research-laboratory-test-in-cerebrospinal-fluid-in-the-diagnosis-of-neurosyphilis-a-case-control-study
#13
S Zheng, R J Lin, Y H Chan, C C L Ngan
BACKGROUND: There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL) test from cerebrospinal fluid (CSF) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive. OBJECTIVE: In this study, we compared the clinical and laboratory characteristics of true-positive VDRL-CSF cases with biological false-positive VDRL-CSF cases. METHODS: We retrospectively identified cases of true and false-positive VDRL-CSF across a 3-year period received by the Immunology and Serology Laboratory, Singapore General Hospital...
November 8, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29090106/orofacial-involuntary-movements-in-neurosyphilis-beyond-the-candy-sign
#14
Abhishek Lenka, Naveen Thota, Albert Stezin, Pramod Kumar Pal, Ravi Yadav
BACKGROUND: Involvement of the central nervous system in patients with syphilis (neurosyphilis) may result in several neuropsychiatric symptoms. Rarely, patients with neurosyphillis may develop movement disorders with different phenomenology. Subtle orofacial dyskinesias have been reported in patients with neurosyphilis, known as the candy sign. CASE REPORT: We describe a patient with neurosyphilis who presented with severe orofacial involuntary movements. DISCUSSION: Our patient had orofacial movements at presentation and severity of the movements was much higher than the candy sign that has been reported in patients with neurosyphilis...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/29081366/central-nervous-system-infections-in-the-absence-of-cerebrospinal-fluid-pleocytosis
#15
Hakan Erdem, Derya Ozturk-Engin, Yasemin Cag, Seniha Senbayrak, Asuman Inan, Esra Kazak, Umit Savasci, Nazif Elaldi, Haluk Vahaboglu, Rodrigo Hasbun
Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated...
November 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29069031/clinical-manifestations-and-treatment-outcomes-of-syphilitic-uveitis-in-hiv-negative-patients-in-china-a-retrospective-case-study
#16
Jiang Zhu, Yuan Jiang, Yewen Shi, Bo Zheng, Zhiguo Xu, Wei Jia
Syphilitic chorioretinitis should be included in differential diagnosis of any form of ocular inflammation. A significantly higher proportion of human immunodeficiency virus (HIV)-positive patients with ocular syphilis as compared to HIV-negative cases have been reported in published studies. However, the clinical signs and symptoms are more insidious in HIV-negative patients who are easily misdiagnosed. We report a series of cases of ocular syphilis and describe the clinical manifestations and treatment outcomes of syphilitic chorioretinitis in HIV-negative patients in China...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29053397/combined-intravitreal-and-systemic-antibiotic-therapy-in-a-patient-with-syphilitic-uveitis
#17
Arjun B Sood, William A Pearce, Kimberly A Workowski, James Lockwood, Steven Yeh
PURPOSE: To report the novel use of combined intravitreal and systemic antibiotic therapy in a patient with syphilitic panuveitis and discuss the management of ocular syphilis. METHODS: Case report Results: A 45-year old heterosexual male with human immunodeficiency virus (HIV) presented with 1 month of blurry vision in both eyes. Clinical examination revealed a bilateral panuveitis. The patient denied history of genital lesions or rash, but did complain of difficulty hearing bilaterally...
October 20, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29037341/-neurosyphilis-an-age-old-problem-that-is-still-relevant-today
#18
Juliana Galindo, Juan Felipe Mier, Carlos Alberto Miranda, Juan Carlos Rivas
Neurosyphilis is the clinical manifestation of syphilis that can arise during either the early or late stages of infection. Even though dedicated treatment for all clinical forms of syphilis has been available for many years, the advanced stages of the disease are still prevalent, with irreversible sequelae. This article reviews the current evidence, diagnostic methods and specific treatment for tertiary syphilis.
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/29020491/ocular-syphilis-an-update
#19
Parthopratim Dutta Majumder, Elizabeth J Chen, Janika Shah, Dawn Ching Wen Ho, Jyotirmay Biswas, Leo See Yin, Vishali Gupta, Carlos Pavesio, Rupesh Agrawal
This review aims to provide an update on the clinical presentation, diagnosis, and treatment of ocular syphilis. While ocular syphilis is not a new phenomenon, recent resurgence in the incidence of overall syphilis, particularly among HIV-positive individuals, has sparked a new interest in an old disease. The challenge of ocular syphilis is manifold: firstly, it manifests in a spectrum of ways that can occur at any stage of the disease, with the most common finding being panuveitis. It may occur as early as 6 weeks after transmission and may be the only presenting feature of systemic syphilis; secondly, the relationship between HIV and syphilis has been established, as primary syphilis facilitates HIV transmission and HIV may modify the natural course of syphilis, increasing the propensity of the disease to progress to neurosyphilis...
October 11, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29020214/how-well-do-neurologic-symptoms-identify-individuals-with-neurosyphilis
#20
Arielle P Davis, Joshua Stern, Lauren Tantalo, Sharon Sahi, Sarah Holte, Shelia Dunaway, Christina M Marra
Background: Current guidelines recommend lumbar puncture (LP) in patients with syphilis who have neurologic syndromes. Methods: 81 HIV-uninfected individuals and 385 HIV-infected individuals enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent LP and a structured symptom history, including assessment of headache; stiff neck; photophobia; ocular inflammation; vision, hearing or sensory loss; or gait incoordination. Neurosyphilis was defined as a reactive CSF-Venereal Disease Research Laboratory (VDRL) test...
September 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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