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https://www.readbyqxmd.com/read/28414665/a-case-of-early-neurosyphilis
#1
M Walker, R Wisler, J Simmons, A Johnson
INTRODUCTION: Neurosyphilis is an infection of the central nervous system by Treponema pallidum, which can occur after the initial syphilis infection. Although commonly associated with late stage disease, patients with early neurosyphilis may present with acute syphilitic meningitis, meningovascular syphilis, or uveitis. CASE: A 28 year old man with a past medical history of HIV (CD4 364);, and recent diagnosis of uveitis presented to the Emergency Department with a positive RPR result...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28397100/the-burden-and-epidemiology-of-community-acquired-central-nervous-system-infections-a-multinational-study
#2
H Erdem, A Inan, E Guven, S Hargreaves, L Larsen, G Shehata, E Pernicova, E Khan, L Bastakova, S Namani, A Harxhi, T Roganovic, B Lakatos, S Uysal, O R Sipahi, A Crisan, E Miftode, R Stebel, B Jegorovic, Z Fehér, C Jekkel, N Pandak, A Moravveji, H Yilmaz, A Khalifa, U Musabak, S Yilmaz, A Jouhar, N Oztoprak, X Argemi, M Baldeyrou, G Bellaud, R V Moroti, R Hasbun, L Salazar, R Tekin, A Canestri, L Čalkić, L Praticò, F Yilmaz-Karadag, L Santos, A Pinto, F Kaptan, P Bossi, J Aron, A Duissenova, G Shopayeva, B Utaganov, S Grgic, G Ersoz, A K L Wu, K C Lung, A Bruzsa, L B Radic, H Kahraman, M Momen-Heravi, S Kulzhanova, F Rigo, M Konkayeva, Z Smagulova, T Tang, P Chan, S Ahmetagic, H Porobic-Jahic, F Moradi, S Kaya, Y Cag, A Bohr, C Artuk, I Celik, M Amsilli, H C Gul, A Cascio, M Lanzafame, M Nassar
Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure...
April 10, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28381602/cerebrospinal-fluid-treponema-pallidum-particle-agglutination-assay-for-neurosyphilis-diagnosis
#3
Christina M Marra, Clare L Maxwell, Shelia B Dunaway, Sharon K Sahi, Lauren C Tantalo
BACKGROUND: Limited data suggest that the cerebrospinal fluid (CSF) Treponema pallidum particle agglutination assay (TPPA) is sensitive and a CSF Treponema pallidum hemagglutination assay (TPHA) titer ≥1:640 is specific for neurosyphilis diagnosis. METHODS: CSF-TPPA reactivity and titer were determined for a convenience sample of 191 CSFs from individuals enrolled in a study of CSF abnormalities in syphilis (training dataset). Sensitivity of a reactive test and specificity for reactivity at serial higher CSF dilutions was determined...
April 5, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28338084/late-neurosyphilis-and-tertiary-syphilis-in-guangdong-province-china-results-from-a-cross-sectional-study
#4
Weiming Tang, Shujie Huang, Lei Chen, Ligang Yang, Joseph D Tucker, Heping Zheng, Bin Yang
Due to challenges in diagnosis and the need for complex laboratory tests, misdiagnosis of neurosyphilis and tertiary syphilis is common in China. We validated the diagnosis and examined the treatment of late neurosyphilis and tertiary syphilis in Guangdong Province, China. A cross-sectional study was conducted to collect data from late neurosyphilis and tertiary syphilis cases reported between 2009 and 2014 in Guangdong, China. Descriptive analysis, bivariate analyses and multiple logistic regressions were performed to determine the structural factors associated with correct diagnosis and standard treatment of late neurosyphilis and tertiary syphilis...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28291299/-neurosyphilis-in-psychiatric-settings-three-case-reports
#5
Erhan Akıncı, Fatih Öncü, Barış Topçular
Syphilis is a generally sexually transmitted and multisystem disease caused by the spirochete Treponema pallidum. All of the organs of the body may be involved during the course of the disease. Neurosyphilis is a clinical form of syphilis with the central nervous system (CNS) involvement. While primarily meningeal and vascular structures are involved in early neurosyphilis, a parenchymal affection of the brain and spinal cord emerges at later stages of neurosyphilis. It presents with symptoms of meningitis, meningovasculitis and parenchymal neurosyphilis (presenting as tabes dorsalis and general paresis)...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28288165/neutropenia-induced-by-high-dose-intravenous-benzylpenicillin-in-treating-neurosyphilis-does-it-really-matter
#6
Rui-Rui Peng, Juan Wu, Wei Zhao, Tengfei Qi, Mei Shi, Zhifang Guan, Haikong Lu, Fuquan Long, Zixiao Gao, Sufang Zhang, Pingyu Zhou
BACKGROUND: Prompt therapy with high-dose intravenous benzylpenicillin for a prolonged period is critical for neurosyphilis patients to avoid irreversible sequelae. However, life-threatening neutropenia has been reported as a complication of prolonged therapy with high doses of benzylpenicillin when treating other diseases. This study aimed to investigate the incidence, presentation, management and prognosis of benzylpenicillin-induced neutropenia in treating neurosyphilis based on a large sample of syphilis patients in Shanghai...
March 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28220718/the-big-imitator-strikes-again-a-case-report-of-neurosyphilis-in-a-patient-with-newly-diagnosed-hiv
#7
Sévérine de Bruijn, Chris Kenyon, Nicolas Léonard, Erika Vlieghe
BACKGROUND: Neurosyphilis is the result of an infection of the central nervous system caused by the spirochete Treponema pallidum. Its clinical presentation includes meningovascular syphilis, tabes dorsalis, and dementia paralytica, resulting in a wide range of symptoms such as psychosis, Parkinsonism, and depression. CASE REPORT: A 49-year-old male was admitted to a psychiatric hospital because of social withdrawal and self-neglect, indicative of a major depression...
February 21, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28217607/concurrent-central-nervous-system-infective-pathology-in-a-severely-immunocompromised-patient
#8
Thein Swe, Bordes P Laurent, Nickul N Shah
To our knowledge and literature search, concurrent cryptococcal meningitis and neurosyphilis in a patient have rarely been reported. Here, we report a 37-year-old male with HIV infection presented with headache and dizziness for 5 days along with memory difficulty and personality changes for about 1 week. During the hospital stay, cryptococcal meningitis was confirmed with positive cerebral spinal fluid (CSF) cryptococcal antigen titer (1:320) and positive CSF culture. Diagnosis of neurosyphilis was made based upon CSF white blood cell count of 85 cells/μL, with CSF total protein of 87 mg/dL, reactive CSF treponemal antibody, and fluorescent treponemal antibody...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28196838/screening-for-asymptomatic-neurosyphilis-in-hiv-patients-after-treatment-of-early-syphilis-an-observational-study
#9
Andrew Tomkins, Shazaad Ahmad, Darren E Cousins, Caroline M Thng, Francisco Javier Vilar, Stephen P Higgins
OBJECTIVE: To determine the prevalence of asymptomatic neurosyphilis (ANS) in HIV-positive individuals after treatment of early syphilis with single-dose benzathine penicillin G (BPG) or oral antibiotic alternatives. METHODS: Patients at high risk of neurosyphilis (defined by serum rapid plasma reagin (RPR) titre ≥1:32 and/or peripheral blood CD4 lymphocyte count ≤350/μL) underwent lumbar puncture (LP) at a median time of 8.2 months post treatment. ANS was diagnosed by a reactive cerebrospinal fluid (CSF) RPR test or CSF white blood cells (WBC) >20/μL plus a reactive CSF Treponema pallidum particle agglutination (TPPA) ≥1:640...
February 14, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28192580/a-brief-resolved-unexplained-event-and-congenital-neurosyphilis
#10
Justin Triemstra, Kelsey Reno, Rebecca Chohlas-Wood, Colleen Nash
Brief resolved unexplained event (BRUE) is a common pediatric problem that presents to ambulatory and emergency settings. Infants presenting with a BRUE can be separated into low- and high-risk groups per recent guidelines. Most low-risk infants who present with a BRUE can be discharged home with anticipatory guidance and education provided to the caregivers; however, high-risk infants should undergo further testing and observation to determine the cause of their event. Congenital neurosyphilis can be a rare cause of a BRUE...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28190667/repeated-episodes-of-acute-stroke-as-manifestation-of-neurosyphilis-in-a-well-controlled-human-immunodeficiency-virus-infected-patient-successful-treatment-with-ceftriaxone
#11
Tsung-Chia Chen, Jen-Hsien Wang, Tzung-Chang Tsai
No abstract text is available yet for this article.
February 9, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28143443/the-immunological-response-to-syphilis-differs-by-hiv-status-a-prospective-observational-cohort-study
#12
Chris Kenyon, Kara Krista Osbak, Tania Crucitti, Luc Kestens
BACKGROUND: It is not known if there is a difference in the immune response to syphilis between HIV-infected and uninfected individuals. METHODS: We prospectively recruited all patients with a new diagnosis of syphilis and tested their plasma for IFNα, IFNγ, IL-1β, IL-12p40, IL-12p70, IP-10, MCP-1, MIP-1α, MIP-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10 and IL-17A at baseline pre-treatment and 6 months following therapy. RESULTS: A total of 79 HIV-infected [44 primary/secondary syphilis (PSS) and 35 latent syphilis (LS)] and 12 HIV-uninfected (10 PSS and 2 LS) cases of syphilis and 30 HIV-infected controls were included in the study...
January 31, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28115606/teaching-video-neuroimages-candy-sign-the-clue-to-the-diagnosis-of-neurosyphilis
#13
João Pedro Marto, Cláudia Borbinha, Tânia Lampreia, Luísa Alves, Miguel Viana-Baptista
No abstract text is available yet for this article.
January 24, 2017: Neurology
https://www.readbyqxmd.com/read/28093716/syphilitic-chancre-and-condylomata-lata-possibly-coexisting-with-neurosyphilis
#14
Yoav C Metzger, Mor Miodovnik, Shmuel Epshteyn
No abstract text is available yet for this article.
March 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28056870/anti-n-methyl-d-aspartate-receptor-nmdar-antibody-encephalitis-presents-in-atypical-types-and-coexists-with-neuromyelitis-optica-spectrum-disorder-or-neurosyphilis
#15
Kaiyu Qin, Wenqing Wu, Yuming Huang, Dongmei Xu, Lei Zhang, Bowen Zheng, Meijuan Jiang, Cheng Kou, Junhua Gao, Wurong Li, Jinglin Zhang, Sumei Wang, Yanfei Luan, Chaoling Yan, Dan Xu, Xinmei Zheng
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a clinically heterogeneous disorder characterized by epileptic seizures, psychosis, dyskinesia, consciousness impairments, and autonomic instability. Symptoms are always various. Sometimes it presents in milder or incomplete forms. We report 4 cases of anti-NMDAR encephalitis with incomplete forms, 3 cases of which were accompanied by neuromyelitis optica spectrum disorder or neurosyphilis respectively. CASE PRESENTATION: A 33-year-old man presented with dysarthria, movement disorder and occasional seizures...
January 5, 2017: BMC Neurology
https://www.readbyqxmd.com/read/27998455/-optic-nerve-subarachnoid-space-expansion-in-mr-imaging-a-etiology-study
#16
M Li, Q G Xu, J Q Wang, Y R Wang, J Zhao, S H Wei
Objective: To investigate spectrum of causes in optic nerve subarachnoid space (ONSS) expansion by using Magnetic Resonance Imaging (MRI). Methods: A retrospective study. Twenty-six patients (46 eyes) with ONSS expansion and 20 healthy adults (40 eyes) were recruited in Neuro-ophthalmology Department of Chinese PLA General Hospital from January, 2014 to December, 2015. The diameters were measured on the optic nerve (OND) and optic nerve sheath (ONSD) 2.4 mm behind the globe. ONSS was calculated by the formula of (ONSD-OND)/2...
December 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/27998453/-clinical-features-of-neurosyphilis-with-optic-neuritis-as-an-initial-finding
#17
S S Cao, H Y Li, Q G Xu, S Y Tan, S H Wei
Objective: To study the characteristics of neurosyphilis with optic neuritis as an initial finding. Methods: Retrospective analysis of clinical data and laboratory testing results of 16 cases (27 eyes) with optic neuritis as an initial finding of neurosyphilis from October 2010 to March 2015 in General Hospital of People's Liberation Army was made. Results: Six-teen patients (12 males, 4 females) were collected, the median age of patients was 47 (range 33 to 65) years ,the mean age was (49.63±9.05) years. Treponema pallidum particle agglutination assay (TPPA) analysis was positive in all of the patients and rapid plasma reagin (RPR) test was positive in 14 patients (2 patients did not test)...
December 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/27980287/a-case-of-neurosyphilis-presenting-with-limbic-encephalitis
#18
Kazuto Tsukita, Akihiro Shimotake, Mitsuyoshi Nakatani, Yukitoshi Takahashi, Akio Ikeda, Ryosuke Takahashi
A 46-year-old man presented with a history of personality change and memory disturbance for 5 months. He gradually became difficult in doing a daily job. Brain MRI showed abnormal hyperintensity within bilateral mesial temporal lobes on T2 weighted image. Therefore, viral and autoimmune limbic encephalitis was initially suspected. However, because treponemal and non-treponemal specific antibodies were positive in serum and cerebrospinal fluid (CSF), the diagnosis of neurosyphilis was made. Patients of neurosyphilis with mesiotemporal T2 weighted hyperintensity reportedly showed common features such as relatively young age, HIV-negative, subacute cognitive impairment and seizure, as seen in our patient...
December 16, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27956326/syphilitic-posterior-placoid-chorioretinitis-as-initial-presentation-of-early-neurosyphilis
#19
F E Molina-Sócola, F López-Herrero, A Medina-Tapia, T Rueda-Rueda, M Contreras-Díaz, J L Sánchez-Vicente
CASE REPORT: A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. DISCUSSION: Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis...
December 7, 2016: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/27917762/revisiting-an-old-foe-the-face-of-psychosis-in-neurosyphilis
#20
Y Moolla, J Abdul
A delusional, agitated middle-aged man presented to hospital with a tenacious psychotic episode. Upon appropriate therapy for neurosyphilis, dramatic resolution of this brief episode ensued, prompting a literature review of psychosis associated with neurosyphilis.
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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