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Cureus 2022 May 19;14(5):e25132. Epub 2022 May 19.

Infectious Diseases, University of Florida College of Medicine, Jacksonville, USA.

Syphilis has been called "the great masquerader." In this case report, we present a case of an HIV-negative patient with left eye redness and decreased vision. Syphilitic anterior uveitis as a complication of neurosyphilis was subsequently diagnosed and the patient showed marked improvement with treatment. Read More

Front Immunol 2022 27;13:872286. Epub 2022 May 27.

Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

infection in the central nervous system is a severe infectious disease with poor outcomes and high mortality. It has been estimated that there are 220,000 new cases each year. Over 90% of meningitis cases were diagnosed in AIDS patients with CD4 T cell count <100 cells/μl; however, the mechanism of cryptococcal meningitis in patients with normal immune functions remains unclear. Read More

J Community Hosp Intern Med Perspect 2022 12;12(2):10-13. Epub 2022 Apr 12.

Trinitas Regional Medical Center, Department of Internal Medicine, 225 Williamson Street Elizabeth, NJ 07202, USA.

Syphilis is a sexually transmitted disease spread by spirochete Treponema Pallidum, it has a varied range of symptoms and is divided into stages primary, secondary and tertiary. Central nervous system (CNS) invasion occurs early in the disease in almost all the patients, and does not follow any particular stage. However, clinical manifestation depends on whether inflammatory response occurs. Read More

J Community Hosp Intern Med Perspect 2022 2;12(3):57-60. Epub 2022 May 2.

Cape Fear Valley Medical Center, Fayetteville, NC.

Neurosyphilis is the progression of the untreated sexually transmitted infection caused by . When the initial infection is not adequately treated, progression of primary syphilis can lead to a wide variety of serious health sequelae. While neurosyphilis can appear up to 10-30 years after the initial infection, syphilis can invade the nervous systemat any stage of infection and can imitate symptoms of many other diseases. Read More

Front Neurol 2022 27;13:879643. Epub 2022 May 27.

Department of Neurology, Zhongshan Hospital, Xiamen University, Xiamen, China.

Background: Neurosyphilis (NS) lacks specificity in clinical and imaging features, and patients are frequently misdiagnosed as viral encephalitis when they present with seizures. This study aimed to compare electroencephalography (EEG) in patients with seizures resulting from the two diseases and provide guidance for differential diagnosis.

Methods: A retrospective study on patients diagnosed with neurosyphilis and viral encephalitis with seizures in the Department of Neurology, Zhongshan Hospital, Xiamen University from 2012 to 2020. Read More

Curr Top Microbiol Immunol 2022 Jun 16. Epub 2022 Jun 16.

KEMRI-Wellcome Trust Research Program, Kilifi, Kenya.

Controlled human infection studies have contributed significantly to the understanding of pathogeneses and treatment of infectious diseases. In malaria, deliberately infecting humans with malaria parasites was used as a treatment for neurosyphilis in the early 1920s. More recently, controlled human malaria infection (CHMI) has become a valuable, cost-effective tool to fast-track the development and evaluation of new anti-malarial drugs and/or vaccines. Read More

Front Med (Lausanne) 2022 20;9:757354. Epub 2022 May 20.

Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Background: In recent years, the incidence of syphilis has increased year by year. Our study is to explore the risk factors for the development of neurosyphilis in patients who failed syphilis treatment.

Methods: A total number of 165 patients with complete medical records and who agreed to undergo lumbar puncture were divided into 47 neurosyphilis cases and 118 non-neurosyphilis cases according to the diagnostic criteria of neurosyphilis, and the differences in clinical characteristics and laboratory features between the two groups were analyzed. Read More

Ticks Tick Borne Dis 2022 May 25;13(5):101971. Epub 2022 May 25.

Department of Immunology and Microbiology, Costerton Biofilm Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Microbiology, Copenhagen University hospital-Rigshospitalet, Copenhagen, Denmark. Electronic address:

Background: Diagnosing Lyme neuroborreliosis (LNB) is complicated by a lack of adequate test systems and by the complex culturing conditions required to grow the causative pathogens in the Borrelia sensu lato complex. Improved testing methods are urgently needed. Here, we evaluate the applicability of a novel commercially available Borrelia-specific real-time PCR assay to diagnose LNB. Read More

Front Med (Lausanne) 2022 13;9:894841. Epub 2022 May 13.

Department of Clinical Prevention and Control of STD, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China.

Considered the increased threaten of neurosyphilis in China, a review on cases reported in the literature to describe the clinical epidemiological characteristics of neurosyphilis cases, may be beneficial to the early detection and management strategies of neurosyphilis for clinicians. We searched the literature on Chinese neurosyphilis cases published from January 1, 2009 to December 31, 2021, described their clinical epidemiological characteristics and calculated the prevalence of neurosyphilis amongst other associated diseases, according to the individual study criteria. A total of 284 studies including 7,486 neurosyphilis cases were included. Read More

Front Neurol 2022 12;13:862175. Epub 2022 May 12.

Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.

Neurosyphilis (NS) is an infection of the central nervous system caused by Treponema pallidum. It mimics various neurological and psychiatric diseases. In recent years, there have been several NS cases that manifest as limbic encephalitis (LE). Read More

BMJ Case Rep 2022 May 31;15(5). Epub 2022 May 31.

Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, Gelderland, The Netherlands

Temporal arteritis is usually caused by giant cell arteritis (GCA). However, inflammation of the temporal artery can also occur secondary to autoimmune diseases or infections.We present a remarkable case of a man in his 70s with biopsy proven temporal arteritis, who was later diagnosed with meningovascular neurosyphilis. Read More

Cogn Behav Neurol 2022 06 1;35(2):140-146. Epub 2022 Jun 1.

Unit of Neurology V and Neuropathology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy.

We present the case of a man exhibiting a clinical phenotype of behavioral variant of frontotemporal dementia (bvFTD). The man had developed psychiatric disturbances with verbal aggressiveness over a few months, followed by cognitive and frontal behavioral disorders, fulfilling the clinical criteria for bvFTD. Atrophy and hypometabolism in frontotemporal regions were consistent with the diagnosis. Read More

Front Med (Lausanne) 2022 28;9:877186. Epub 2022 Apr 28.

Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.

The manufacturer's instructions for the venereal disease research laboratory (VDRL) antigen test for diagnosing neurosyphilis describe testing of serum samples and do not include procedures for cerebrospinal fluid (CSF) testing. This study compared the CSF-VDRL test with 10 μL of antigen (CSF-VDRL-10) according to the American Public Health Association to the CSF-VDRL test with 17 μL of antigen (CSF-VDRL-17) according to the VDRL serum procedure. A total of 121 neurosyphilis patients and 86 syphilis/non-neurosyphilis patients were included. Read More

Neurol India 2022 Mar-Apr;70(2):682-688

Department of Neurology, Zhongshan Hospital, Xiamen University, Xiamen, China.

Background: Blood-brain barrier (BBB) is frequently disrupted in patients with diabetes mellitus (DM) and/or neurosyphilis (NS). Clinical cases reflect a trend that non-neurosyphilis (non-NS) patients with impaired glucose tolerance (IGT) are likely to develop NS and/or DM.

Objective: To investigate whether IGT promotes BBB disruption in patients with non-NS. Read More

J Infect Chemother 2022 08 6;28(8):1084-1091. Epub 2022 May 6.

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India. Electronic address:

Ugeskr Laeger 2022 03;184(13)

Hudklinikken Panoptikon.

This review focuses on typical and atypical manifestations of neurosyphilis. The manifestations of neurosyphilis are manyfold and may involve many specialties. Today, clinicians have limited experience with the well-described manifestations of neurosyphilis. Read More

Cureus 2022 Mar 24;14(3):e23468. Epub 2022 Mar 24.

Immunology, Allergy, and Retrovirology, Texas Children's Hospital/Baylor College of Medicine, Houston, USA.

A high index of suspicion and a thorough neurotologic examination at the onset of presentation are imperative to generate the diagnosis of otosyphilis. Complete audiologic recovery is rare but possible in approximately 20%-25% of patients after appropriate treatment. We present a case of reversible hearing loss secondary to otosyphilis in a teenage male patient with a new diagnosis of human immunodeficiency virus (HIV). Read More

Cureus 2022 Mar 26;14(3):e23509. Epub 2022 Mar 26.

Internal Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PRT.

Neurosyphilis refers to the involvement of the central nervous system by . Ocular syphilis can present with a range of manifestations, uveitis being the most common, and it can occur at any stage of acquired syphilis. There are multiple tests available for the diagnosis of syphilis. Read More

Sex Health 2022 Apr 28. Epub 2022 Apr 28.

Background: Neurosyphilis can present in a myriad of ways, making the suspicion and diagnosis of this disease a great challenge for the clinician.

Methods: We present a case of a 54-year-old patient who initially presented with cognitive changes and was eventually found to have new onset refractory status epilepticus.

Results: Neurosyphilis is still a frequent entity nowadays, with involvement of both HIV positive and negative patients. Read More

Neurohospitalist 2022 Apr 10;12(2):400-403. Epub 2022 Feb 10.

Department of Neurology, MedStar Washington Hospital Center, Washington, DC, USA.

Syphilitic myelitis is an unusual manifestation of neurosyphilis, rarely reported in the literature. The best management approach remains unclear in severe cases with longitudinally extensive spinal cord lesions. We describe a 29-year-old man with a history of incompletely treated syphilis after a high-risk sexual encounter, who presented two years later with several weeks of progressive numbness and weakness in both legs. Read More

Clin Infect Dis 2022 04;74(Suppl_2):S127-S133

Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

A panel of experts generated 5 "key questions" in the management of adult syphilis. A systematic literature review was conducted and tables of evidence were constructed to answer these questions. Available data suggest no clinical benefit to >1 dose of benzathine penicillin G for early syphilis in human immunodeficiency virus (HIV)-infected patients. Read More

Malar J 2022 Apr 7;21(1):117. Epub 2022 Apr 7.

Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, 98195, Seattle, USA.

Background: Accurate estimation of the burden of Plasmodium falciparum is essential for strategic planning for control and elimination. Due in part to the extreme heterogeneity in malaria exposure, immunity, other causes of disease, direct measurements of fever and disease attributable to malaria can be difficult. This can make a comparison of epidemiological metrics both within and between populations hard to interpret. Read More

Int J Med Microbiol 2022 May 14;312(4):151553. Epub 2022 Mar 14.

Institution of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang 421001, China. Electronic address:

Background: Neurosyphilis is a serious complication caused by the invasion of the central nervous system by Treponema pallidum subsp. pallidum (T. pallidum). Read More

Eur J Med Res 2022 Mar 27;27(1):49. Epub 2022 Mar 27.

Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Background: Neurosyphilis refers to infection of the central nervous system by Treponema pallidum. The clinical presentation is variable and nonspecific. Neuroimaging findings are complex and that the diagnosis is based on clinical presentation, cerebrospinal fluid (CSF) parameters, and serologic and CSF evidence of syphilis. Read More

HIV Med 2022 Mar 27. Epub 2022 Mar 27.

Department of Infectious Diseases, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil.

Objective: Our objective was to describe and compare the occurrence of neurological outcomes and neurosyphilis in people living with HIV with incident syphilis and no neurological symptoms who underwent early screening for asymptomatic neurosyphilis (ANS) or regular clinical management without a lumbar puncture.

Methods: This was a retrospective cohort study in a single referral centre of Sao Paulo, Brazil. Patients with incident syphilis diagnosed between January 2000 and August 2016 and meeting the adapted criteria for ANS investigation suggested by Marra et al. Read More

Med J Malaysia 2022 03;77(2):267-270

Hospital Ampang, Infectious Disease Unit, Malaysia.

Acute or subacute transverse myelitis is a rare disease caused by inflammation of the spinal cord. The extensive differential diagnosis of this disease require physician to timely decide the necessary investigations and plan for effective treatment. We report a case of anomalous multifactorial transverse myelitis in a patient with human immunodeficiency virus (HIV) who responded well with multimodal therapy. Read More

Trop Med Infect Dis 2022 Mar 8;7(3). Epub 2022 Mar 8.

Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia.

Malignant syphilis (MS) is a rare form of secondary syphilis with grotesque skin lesions, systemic manifestation and life-threatening complications. This article presents a case of MS in an immunocompetent 41-year-old female, who initially manifested with a generalized nonpruritic erythematous rash and systemic symptoms. She was mistreated for generalized impetigo and hepatitis attributed to chronic alcoholism. Read More

Radiol Case Rep 2022 May 18;17(5):1620-1625. Epub 2022 Mar 18.

Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.

Despite widespread screening and active management of syphilis infection, the rate of secondary and tertiary syphilis has increased over the past decade in the United States, especially with human immunodeficiency virus co-infection. We report a case of ischemic strokes in the middle cerebral artery (MCA) territory with focal stenosis of the left M1 segment of the MCA resulting from neurosyphilis with manifestation of subacute intermittent right-sided hemi-body numbness and transient word finding difficulties in a young adult with no prior known history of syphilis or significant cerebrovascular risk factors. A diagnostic cerebral angiogram was done which was initially concerning for possibility of reversible cerebral vasoconstriction syndrome (RCVS). Read More

Microbiol Spectr 2022 Apr 22;10(2):e0177221. Epub 2022 Mar 22.

STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

Treponema pallidum can invade any organ, and T. pallidum DNA can be detected in various tissues and fluids. However, the knowledge of the presence and loads of T. Read More

Gen Psychiatr 2022 28;35(1):e100674. Epub 2022 Feb 28.

General Psychiatry, South West Yorkshire Partnership NHS Foundation Trust, Halifax, UK.

Neurosyphilis can mimic many neurological and psychiatric disorders. Though several of its varied central nervous system manifestations can be measured clinically and by neuroimaging, they are non-specific. Thus, this mimicry and the relative rarity of the illness in the present era make the diagnosis elusive. Read More