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Neurosyphilis

MedGen UID:
14360
•Concept ID:
C0027927
•
Disease or Syndrome
Synonyms: Central Nervous System Syphilis; Syphilis, Central Nervous System; Syphilis, CNS
SNOMED CT: Neurosyphilis (26039008); Syphilis of central nervous system (26039008)
 
Monarch Initiative: MONDO:0004944

Definition

Infection of the brain or spinal cord by Treponema pallidum. It occurs many years following the original infection which remained untreated. Signs and symptoms include abnormal gait, blindness, depression, paralysis, seizures and dementia. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNeurosyphilis

Professional guidelines

PubMed

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management.
Ren M, Dashwood T, Walmsley S
Curr HIV/AIDS Rep 2021 Aug;18(4):280-288. Epub 2021 Jun 6 doi: 10.1007/s11904-021-00564-z. PMID: 34091858Free PMC Article
Ceftriaxone compared with benzylpenicillin in the treatment of neurosyphilis in France: a retrospective multicentre study.
Bettuzzi T, Jourdes A, Robineau O, Alcaraz I, Manda V, Molina JM, Mehlen M, Cazanave C, Tattevin P, Mensi S, Terrier B, Régent A, Ghosn J, Charlier C, Martin-Blondel G, Dupin N
Lancet Infect Dis 2021 Oct;21(10):1441-1447. Epub 2021 May 26 doi: 10.1016/S1473-3099(20)30857-4. PMID: 34051142
Treatment of syphilis: a systematic review.
Clement ME, Okeke NL, Hicks CB
JAMA 2014 Nov 12;312(18):1905-17. doi: 10.1001/jama.2014.13259. PMID: 25387188Free PMC Article

Recent clinical studies

Etiology

Clinical and laboratory characteristics of asymptomatic and symptomatic neurosyphilis in HIV-infected patients: A retrospective study in China.
Miao R, Zhang W, Ding X, Li W, Zhang L, Kou C, Han N, Huang Y
Medicine (Baltimore) 2024 Sep 6;103(36):e39617. doi: 10.1097/MD.0000000000039617. PMID: 39252220Free PMC Article

Diagnosis

Coinfection of cerebral toxoplasmosis and neurosyphilis as the first manifestation of AIDS.
Duffus E, Chinta S, Patel P, Finkel DG
BMJ Case Rep 2024 Sep 18;17(9) doi: 10.1136/bcr-2024-261502. PMID: 39299714
Analysis of brain activity for speech stimuli and child development of an infant with neurosyphilis: case report.
Vasconcelos IC, Oliveira TDS, Santos AB, Lima MTA, Brazorotto JS, Araujo ADDSN, Morya E, Balen SA
Codas 2024;36(5):e20230303. Epub 2024 Sep 13 doi: 10.1590/2317-1782/20242023303pt. PMID: 39292018Free PMC Article
Syphilis presenting as optic neuritis and subdural haematoma with complicating neuro Jarisch-Herxheimer reaction.
Kaur J, Melgar TA, Abdulhak M, Sand E
BMJ Case Rep 2024 Sep 10;17(9) doi: 10.1136/bcr-2024-260588. PMID: 39256176
Clinical and laboratory characteristics of asymptomatic and symptomatic neurosyphilis in HIV-infected patients: A retrospective study in China.
Miao R, Zhang W, Ding X, Li W, Zhang L, Kou C, Han N, Huang Y
Medicine (Baltimore) 2024 Sep 6;103(36):e39617. doi: 10.1097/MD.0000000000039617. PMID: 39252220Free PMC Article
Differential diagnosis of stroke in a setting of high HIV prevalence in Blantyre, Malawi.
Kumwenda JJ, Mateyu G, Kampondeni S, van Dam AP, van Lieshout L, Zijlstra EE
Stroke 2005 May;36(5):960-4. Epub 2005 Mar 31 doi: 10.1161/01.STR.0000162585.97216.ef. PMID: 15802634

Therapy

State-of-the-Art Review: Neurosyphilis.
Hamill MM, Ghanem KG, Tuddenham S
Clin Infect Dis 2024 May 15;78(5):e57-e68. doi: 10.1093/cid/ciad437. PMID: 37593890
The Modern Epidemic of Syphilis.
Ghanem KG, Ram S, Rice PA
N Engl J Med 2020 Feb 27;382(9):845-854. doi: 10.1056/NEJMra1901593. PMID: 32101666
Neurosyphilis.
Ropper AH
N Engl J Med 2019 Oct 3;381(14):1358-1363. doi: 10.1056/NEJMra1906228. PMID: 31577877
Neurosyphilis.
Gonzalez H, Koralnik IJ, Marra CM
Semin Neurol 2019 Aug;39(4):448-455. Epub 2019 Sep 18 doi: 10.1055/s-0039-1688942. PMID: 31533185
Clinical management of infectious cerebral vasculitides.
Carod Artal FJ
Expert Rev Neurother 2016;16(2):205-21. Epub 2016 Jan 19 doi: 10.1586/14737175.2015.1134321. PMID: 26689107

Prognosis

Cerebrospinal Fluid Analysis.
Shahan B, Choi EY, Nieves G
Am Fam Physician 2021 Apr 1;103(7):422-428. PMID: 33788511
Neurosyphilis.
Gonzalez H, Koralnik IJ, Marra CM
Semin Neurol 2019 Aug;39(4):448-455. Epub 2019 Sep 18 doi: 10.1055/s-0039-1688942. PMID: 31533185
Ocular Syphilis: An Update.
Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Neurosyphilis: Knowledge Gaps and Controversies.
Tuddenham S, Ghanem KG
Sex Transm Dis 2018 Mar;45(3):147-151. doi: 10.1097/OLQ.0000000000000723. PMID: 29420441Free PMC Article
Neurosyphilis.
Marra CM
Continuum (Minneap Minn) 2015 Dec;21(6 Neuroinfectious Disease):1714-28. doi: 10.1212/CON.0000000000000250. PMID: 26633785

Clinical prediction guides

The Utility of Biomarkers in the Clinical Management of Syphilis: A Systematic Review.
Lorenz ZW, Nijhar S, Caufield-Noll C, Ghanem KG, Hamill MM
Sex Transm Dis 2023 Aug 1;50(8):472-478. Epub 2023 Apr 1 doi: 10.1097/OLQ.0000000000001813. PMID: 37010823
T2/FLAIR Hyperintensity in Mesial Temporal Lobe: Challenging Differential Diagnosis.
Moon S
Curr Med Imaging 2022;18(3):285-291. doi: 10.2174/1573405617666210712130555. PMID: 34931987
Neurodegenerative proteinopathies associated with neuroinfections.
Danics K, Forrest SL, Kapas I, Erber I, Schmid S, Törő K, Majtenyi K, Kovacs GG
J Neural Transm (Vienna) 2021 Oct;128(10):1551-1566. Epub 2021 Jul 5 doi: 10.1007/s00702-021-02371-7. PMID: 34223998Free PMC Article
Ceftriaxone compared with benzylpenicillin in the treatment of neurosyphilis in France: a retrospective multicentre study.
Bettuzzi T, Jourdes A, Robineau O, Alcaraz I, Manda V, Molina JM, Mehlen M, Cazanave C, Tattevin P, Mensi S, Terrier B, Régent A, Ghosn J, Charlier C, Martin-Blondel G, Dupin N
Lancet Infect Dis 2021 Oct;21(10):1441-1447. Epub 2021 May 26 doi: 10.1016/S1473-3099(20)30857-4. PMID: 34051142
Testing for syphilis.
Johnson PC, Farnie MA
Dermatol Clin 1994 Jan;12(1):9-17. PMID: 8143388

Recent systematic reviews

Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines.
Tuddenham S, Ghanem KG
Clin Infect Dis 2022 Apr 13;74(Suppl_2):S127-S133. doi: 10.1093/cid/ciac060. PMID: 35416969Free PMC Article
Neurosyphilis and Lyme neuroborreliosis.
Dersch R, Singh AE
Curr Opin Neurol 2021 Jun 1;34(3):403-409. doi: 10.1097/WCO.0000000000000923. PMID: 33709978
Sensitivity and Specificity of Treponemal-specific Tests for the Diagnosis of Syphilis.
Park IU, Tran A, Pereira L, Fakile Y
Clin Infect Dis 2020 Jun 24;71(Suppl 1):S13-S20. doi: 10.1093/cid/ciaa349. PMID: 32578866Free PMC Article
Neurosyphilis in Africa: A systematic review.
Marks M, Jarvis JN, Howlett W, Mabey DCW
PLoS Negl Trop Dis 2017 Aug;11(8):e0005880. Epub 2017 Aug 31 doi: 10.1371/journal.pntd.0005880. PMID: 28859081Free PMC Article
Treatment of syphilis: a systematic review.
Clement ME, Okeke NL, Hicks CB
JAMA 2014 Nov 12;312(18):1905-17. doi: 10.1001/jama.2014.13259. PMID: 25387188Free PMC Article

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