Neurosyphilis
R. P. Simon
Syphilis and its consequent central nervous system sequelae remain clinical
problems, especially when presenting in the unfamiliar acute meningeal
forms of syphilitic meningitis and meningovascular syphilis. The diagnosis
of neurosyphilis of all types depends on evaluation of spinal fluid
reactivity as evidenced by pleocytosis and increased protein content with
reactive serology. The cerebrospinal fluid is always abnormal in active
disease, and only active disease responds to treatment. Penicillin remains
the drug of choice for all forms of neurosyphilis, but disease progression
has been frequently reported following the use of penicillin G benzathine.
Documentation of cerebrospinal fluid resolution over the months following
penicillin therapy is required to confirm curative treatment.
From the Archives of the AFIP: Central Nervous System Infections Associated with Human Immunodeficiency Virus Infection: Radiologic-Pathologic Correlation
Smith et al.
RadioGraphics 2008;28:2033-2058.
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Reexamining Syphilis: An Update on Epidemiology, Clinical Manifestations, and Management
Kent and Romanelli
The Annals of Pharmacotherapy 2008;42:226-236.
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Biological Basis for Syphilis
LaFond and Lukehart
Clin. Microbiol. Rev. 2006;19:29-49.
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Case 87: Subacute Combined Degeneration
Naidich and Ho
Radiology 2005;237:101-105.
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Neurosyphilis in the modern era
Timmermans and Carr
J. Neurol. Neurosurg. Psychiatry 2004;75:1727-1730.
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Stroke: Epidemiology, Clinical Picture, and Risk Factors: Part I of III
Tegos et al.
ANGIOLOGY 2000;51:793-808.
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Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features
Singh and Romanowski
Clin. Microbiol. Rev. 1999;12:187-209.
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