![]() Parenchymal: Paresis, hyperactive reflexes, Argyll Robertson pupils, illusions/delusions/ hallucinations, memory defects, speech changes.Subacute encephalitic prodrome of headaches, vertigo, insomnia, and psychological abnormalities.Meningovascular: Meningitis together with inflammatory vasculitis leading to stroke syndrome. ![]() Meningeal: Headache, nausea/vomiting, neck stiffness, cranial nerve involvement, seizures, changes in mental status, uveitis, iritis or hearing loss.Patients with early syphilis who have CSF findings may need to be treated as with neurosyphilis, especially in the setting of HIV.Demonstrable in up to 25% of patients with latent infection and up to 40% of primary or secondary cases.RPR titers of ≥ 1:32 are at higher risk of having neurosyphilis, even higher if HIV infected.Continuum of involvement from asymptomatic patient with CSF abnormalities to meningitis and focal neurologic deficits.Ocular syphilis should be considered equivalent to neurosyphilis.Late symptomatic neurosyphilis: tabes dorsalis and paresis.Cardiovascular syphilis: involves the vasa vasorum of the ascending aorta and can result in aneurysm formation.The most common manifestation in the US today is neurosyphilis in HIV infected persons.Characterized by progressively destructive mucocutaneous, musculoskeletal, or parenchymal lesions, aortitis or CNS manifestations.May intermittently be present in the bloodstream and transmitted through blood transfusion or organ donation.Less common complications include: hepatitis, nephropathy, gastritis, proctitis, rectosigmoid mass, arthritis, periositis, optic neuritis, iritis, uveitis, pupillary abnormalities.Can include: sore throat, fever, weight loss, malaise, anorexia, headache, and meningismus Constitutional symptoms may accompany or precede secondary syphilis.CNS involvement can be symptomatic or asymptomatic. CSF abnormalities are detected in as many as 40% during this stage.In intertriginous areas, papules can enlarge to produce broad, moist, pink or gray-white infectious lesions called condylomata lata.The stages may overlap more frequently in HIV patients. Healing chancre may still be present in ~15% of cases. ![]()
0 Comments
Leave a Reply. |