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Chenhui Mao, Jing Gao, Liri Jin, Bin Peng, Yupu Guo
Neurosyphilis occurs in the late stage of systemic syphilis infection; early diagnosis and treatment are crucial to the prognosis. We review 3 autopsy cases with different subtypes of neurosyphilis, that is cases with meningovascular, general paresis, and a combination of the 2, respectively. We investigated the gross morphology and leptomeninges, vessels, cerebral cortex, white matter, brainstem, cerebellum, olfactory bulb and spinal cord microscopically. We found that meningovascular inflammation exists in both early and late phases of neurosyphilis, not only in the meningovascular subtype...
March 12, 2018: Journal of Neuropathology and Experimental Neurology
Antonio Jose Reyes, Kanterpersad Ramcharan, Samuel Aboh, Stanley Lawrence Giddings
No abstract text is available yet for this article.
March 15, 2018: BMJ Case Reports
Ellen N Kersh, Sheila A Lukehart
The first session at the 2016 Syphilis Summit provided an opportunity for laboratory researchers and clinicians to comment on gaps in biomedical knowledge and technologies. Predominant themes in the presentations and discussion included the need for optimization of existing diagnostic tests, commercial availability and FDA approval of nucleic acid amplification tests for primary and secondary syphilis, development of sensitive and specific new blood tests for diagnosis of active (vs. treated) syphilis infection, clarification of the best measures for adequacy of response to treatment, continued study of complications of syphilis including neuro- and ocular syphilis, and development of a safe and effective vaccine that will protect against transmission and complications of disseminated infection (including congenital and neurosyphilis)...
March 9, 2018: Sexually Transmitted Diseases
Helena Sá E Silva, Catarina O Paulo, Frederico Duarte, Ricardo C Abreu, Isabel Neves, Pedro Moniz
No abstract text is available yet for this article.
March 6, 2018: Neurology
Zhenyan Wang, Li Liu, Yin-Zhong Shen, Ren-Fang Zhang, Tang-Kai Qi, Yang Tang, Wei Song, Jun Chen, Hongzhou Lu
Neurosyphilis (NS) is an important component of central nervous system diseases among HIV-infected patients. However, its characteristics are not very clear. A retrospective analysis of clinical and laboratory findings was performed in 92 NS patients with HIV infection from a tertiary hospital in Shanghai, China. The patients had a median age of 38 years and a median CD4 count of 198 cells/μL. In all, 44.6% (41/92) were diagnosed as asymptomatic NS (ANS), 23.9% (22/92) as syphilitic meningitis, 17.4% (16/92) as cerebrovascular NS, and 14...
March 2018: Medicine (Baltimore)
Darko Breitenfeld, Davor Kust, Tomislav Breitenfeld, Marin Prpić, Marko Lucijanić, Davor Zibar, Vedran Hostić, Maja Franceschi, Ante Bolanča
Syphilis is a sexually transmitted, systemic disease caused by the spirochete bacterium Treponema pallidum. The most common mechanism of transmission is sexual intercourse. Although there are several hypotheses, the exact origin of the disease remains unknown. Newly published evidence suggests that the hypothesis supporting the theory of the American origin of the disease is the valid one. Among 1500 analyzed pathographies of composers and musicians, data on ten Anglo-American composers and jazz musicians having suffered from neurosyphilis (tertiary stage of the disease) were extracted for this report...
September 2017: Acta Clinica Croatica
Emily Hobbs, Jaime H Vera, Michael Marks, Andrew William Barritt, Basil H Ridha, David Lawrence
Syphilis is a resurgent sexually transmitted infection in the UK that is disproportionately diagnosed in patients living with HIV, particularly in men who have sex with men. Syphilis appears to present differently in patients with HIV, particularly in those with severe immunosuppression. Progression to neurosyphilis is more common in HIV coinfection and can be asymptomatic, often for several years. The presentations of neurosyphilis vary but can include meningitis, meningovascular disease, general paresis and tabes dorsalis...
February 24, 2018: Practical Neurology
Karen J Vigil, Lucrecia Salazar, Rodrigo Hasbun
We conducted a retrospective study of 549 adults admitted with community-acquired meningitis (CAM) to several hospitals in New Orleans, LA and Houston, TX between 1999 and 2014 to characterize the current epidemiology, clinical manifestations, cerebrospinal fluid (CSF) characteristics, and outcomes of CAM between HIV-infected and uninfected patients and to identify risk factors for adverse outcomes in CAM. Bivariate analysis and logistic regression analysis were used to identify prognostic factors. A total of 1022 patients with CAM were screened...
February 2018: AIDS Patient Care and STDs
Susan Tuddenham, Khalil G Ghanem
After reaching a nadir at the turn of the century, syphilis rates in the United States have increased since 2000. Treponema pallidum may disseminate to the central nervous system within hours to days after inoculation. In this review, we focus on knowledge gaps and areas of controversy in neurosyphilis epidemiology, diagnosis, and management. Modern estimates of the prevalence of neurosyphilis are hindered by the lack of consistent reporting data and are based on relatively small retrospective cohort studies...
March 2018: Sexually Transmitted Diseases
Olivia C Smibert, Adam W J Jenney, Denis W Spelman
Given the long term sequelae of untreated neurosyphilis and insensitive tests to detect treponemes in the cerebrospinal fluid, questions regarding the utility of a lumbar puncture and cerebrospinal fluid analysis either to confirm or exclude neurosyphilis are raised.
February 2018: Internal Medicine Journal
László Tombor, Pál Salacz, Éva Jankelovics, Zoltán Hidasi
The authors present a case of neurosyphilis associated with predominant psychiatric symptoms. The elderly man was admitted because of confused behavior, maniform state, lack of critical judgement and grandiose delusions. On admission, right central facial nerve paresis, hand tremor and parkinsonism were also found. Acute brain imaging and routine laboratory tests failed to identify a firm etiology of the confusional state. The psychiatric treatment resulted in complete recovery from delirium. Afterwards, maniform psychosis dominated the clinical picture for which antipsychotics were administered...
February 2018: Orvosi Hetilap
Ana Iglesias Plaza, Maribel Iglesias Sancho, Mónica Quintana Codina, Javier García Miguel, Montse Salleras Redonnet
Inhibitors of tumor necrosis factor-alpha (anti-TNF-alpha) are widely used in different medical specialties. The main adverse effect of these agents is the increased risk of infection. We report the case of a 30-year-old man with ankylosing spondylitis who had begun receiving golimumab two weeks earlier. He presented with a 10-day history of salmon-colored lesions on trunk, palms and soles. The clinical suspicion was secondary syphilis. Treponemal and nontreponemal tests confirmed the diagnosis of syphilis...
February 2, 2018: Reumatología Clinica
Yongxing Yan, Jun Wang, Bin Qu, Yan Zhang, Yingnan Wei, Huili Liu, Chunli Wu
Neurosyphilis is a chronic infectious disease with involvement of central nervous system infection by Treponema pallidum. This study was to investigate the contents of B lymphocyte chemokine 1 (BLC-1/chemokine [C-X-C motif] ligand 13), Th1 cytokines (Interleukin [IL]-2, IL-12, and Interferon [IFN]-γ), and Th2 cytokines (IL-6 and IL-10) in serum and cerebrospinal fluid (CSF) of HIV-negative patients with neurosyphilis before and after treatment, aiming to elucidate roles of CXCL13 and Th1/Th2 cytokines in immune response to and pathogenesis of neurosyphilis...
November 2017: Medicine (Baltimore)
Carlos Henrique Ferreira Camargo, Hélio Afonso Ghizoni Teive
The gens Julia was one of the oldest families in ancient Rome, whose members reached the highest positions of power. They made history because Julius Caesar, perpetual dictator, great-uncle of the first emperor, Augustus, passed his name on to the Julio-Claudian dynasty with the emperors Tiberius, Caligula, Claudius and Nero. Descriptions of the diseases of these emperors and some of his family members may indicate diagnoses such as epilepsy, dystonia, dementia, encephalitis, neurosyphilis, peripheral neuropathies, dyslexia, migraine and sleep disorders...
January 2018: Arquivos de Neuro-psiquiatria
Patil Anuja, Vishnu Venugopalan, Naheed Darakhshan, Pandit Awadh, Vinny Wilson, Goyal Manoj, Modi Manish, Lal Vivek
BACKGROUND AND PURPOSE: Rapidly progressive dementia (RPD) is an emergency in cognitive neurology, defined as cognitive impairment affecting the daily living activities developed over less than 1 year. This study investigated the profile of patients with rapidly progressive dementia at first presentation. METHODS: Retrospective case analysis was done in 187 patients with rapidly progressive dementia who presented to the Postgraduate Institute of Medical Education and Research, Chandigarh, India from January 2008 to August 2016...
2018: PloS One
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
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
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
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
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
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