User:Mr. Ibrahem/Neurosyphilis
| Mr. Ibrahem/Neurosyphilis | |
|---|---|
 | |
| Section of human skull damaged by late stage neurosyphilis | |
| Specialty | Neurology, Infectious diseases |
| Symptoms | None, headache, stiff neck, numbness, loss of bladder control, personality changes[1][2] |
| Usual onset | Anytime following infection[1] |
| Types | Early, late[1] |
| Causes | Treponema pallidum[1] |
| Risk factors | HIV infection, unprotected sex[1] |
| Diagnostic method | CSF testing (VDRL, FTA-ABS)[3][4] |
| Treatment | Antibiotics (penicillin G, ceftriaxone)[5] |
| Frequency | Rare[1] |
Neurosyphilis refers to infection of the central nervous system by syphilis.[1] It can occur at any time after infection.[1] It may occur with no symptoms, or result in meningitis, stroke symptoms , general paresis, or tabes dorsalis.[1] Meningitis presents with headaches, stiff neck, and vomiting.[1] General paresis may result in personality changes, delusions, and tremor.[1] Tabes dorsalis may result in poor coordination, numbness, bladder problems, and abnormal eye movements.[1][2]
The cause is the bacteria Treponema pallidum.[1] It is more common in those who also have HIV.[1] The diagnosis involves a lumbar puncture to obtain cerebrospinal fluid (CSF) for analysis.[3] If the VDRL test on CSF is positive, this confirms the diagnosis; however, a negative test dose not rule it out.[3] This is sometimes supplemented by fluorescent treponemal antibody absorption testing (FTA-ABS).[4]
Treatment of neurosyphilis is generally with penicillin G at doses of 3 to 4 million units intravenously every four hours for 10 to 14 days.[5] Penicillin may also be given once daily by injection into a muscle together with probenecid by mouth.[2] In those who are allergic to penicillin, ceftriaxone may be used.[5] When treated early outcomes are generally good.[2]
Neurosyphilis is rare, though cases have been increasing.[1][4] In the United States nearly 2% of people with early syphilis had neurosyphilis.[4] Though in parts of Africa about 2% of the general population may be affected.[1] Males are more commonly affected than females.[1] Before the availability of antibiotics about 30% of those with syphilis had neurosyphilis.[1]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r Ha, T; Tadi, P; Dubensky, L (January 2021). "Neurosyphilis". PMID 31082023.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d "Neurosyphilis Information Page". www.ninds.nih.gov. National Institute of Neurological Disorders and Stroke. Archived from the original on 9 April 2021. Retrieved 8 April 2021.
- ^ a b c Peermohamed, Shaqil; Kogilwaimath, Siddharth; Sanche, Stephen (20 July 2020). "Neurosyphilis". Canadian Medical Association Journal. 192 (29): E844–E844. doi:10.1503/cmaj.200189.
- ^ a b c d Ropper, Allan H. (3 October 2019). "Neurosyphilis". New England Journal of Medicine. 381 (14): 1358–1363. doi:10.1056/NEJMra1906228.
- ^ a b c "STD Facts - Syphilis (Detailed)". www.cdc.gov. 23 September 2019. Archived from the original on 30 July 2018. Retrieved 8 April 2021.