Analysis of Fourteen New Cases of Meningovascular Syphilis: Renewed Interest in an Old Problem

Abstract

Neurosyphilis (NS) remains a public health problem. Several recent reports suggest a worldwide increase in the incidence of this condition. Various syndromes can occur in NS, such as syphilitic meningitis, meningovascular syphilis, parenchymatous and gummatous neurosyphilis. Syphilis meningovascular will be the focus of this study. We report 14 new observations of meningovascular syphilis. A review of demographic and clinical features, neuroimaging findings, cerebrospinal fluid changes, treatment and outcome, pathophysiology mechanism of meningovascular syphilis are presented.

Meningovascular Syphilis Presenting as Acute Ischemic Stroke in an HIV + Young Adult: A Case Report and a Brief Literature Review

“…4 It appears to occur more often in relation to HIV, and several research studies indicate that the co-occurrence results in an accelerated advancement of a more severe type of neurosyphilis. 2 However, there have also been numerous instances of syphilitic vasculitis (SV) in young, immunocompetent stroke patients. 5,6 The meningovascular complications of syphilis occur due to a condition called focal syphilitic endarteritis.…”

“…9 In the analysis of 14 new cases of meningovascular syphilis, 71% of the patients had cerebral infarction, which was present in two patients in multiple territories and in a deep region in 28% of all patients. 2 CSF abnormalities occurring in neurosyphilis include pleocytosis (45 WBC per high-power field), low glucose (<2/3 serum glucose), and elevated protein (445 mg/dl). In up to 4% of patients with symptomatic neurosyphilis, CSF protein, glucose, and WBC count may be entirely normal, especially in advanced stages of the disease.…”

Meninigovascular syphilis presenting as acute ischemic stroke in an HIV + young adult: A case report and a brief literature review

“…There have been several reported cases of cerebral infarctions in the past. In the analysis of 14 new cases of meningovascular syphilis, 71% of the patients had cerebral infarction, which was present in two patients in multiple territories and in a deep region in 28% of all patients (10).…”

Stroke in Asia

“…Rhinocerebral mucormycosis and aspergillosis are angioinvasive fungal infection, which can locally invade intracranial vessels leading to ischaemic and haemorrhagic stroke in immunocompromised patients [ 130 ]. Stroke due to meningovascular syphilis can occur at the average of 7 years after the primary infection [ 131 ]. Gnathostomiasis is a parasitic infestation that can migrate to the skin and penetrate into the central nervous system causing subarachnoid haemorrhage and migratory ICH [ 132 ].…”