Status epilepticus with focal neurologic deficits: a rare presentation of Neurosyphilis

Qi, Yunwen; Jiang, Zongze; Xie, Daixin; Lei, Na; Zhang, Cai

doi:10.1016/j.ijid.2022.02.029

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Early neurosyphilis can affect the meninges and central blood vessels, including syphilitic meningitis, meningovascular neurosyphilis and syphilitic gummas, often manifested as headache, nausea, vomiting, blurred consciousness, and neck stiffness; late neurosyphilis affects the spinal cord and brain parenchyma, including general paresis and tabes dorsalis, manifested as ataxia, impaired memory, disorientation, depression, hallucinations, and mania ( 102 , 103 ). Furthermore, as a great imitator, neurosyphilis can mimic a wide range of neurological and psychiatric diseases ( 104 ), including but not limited to autoimmune encephalitis ( 105 ), acute ischemic stroke ( 106 ), status epilepticus ( 107 ), posterior uveitis ( 108 ), asymptomatic optic perineuritis ( 109 ). These phenotypes suggest that T. pallidum can invade and affect one or more components of the CNS.…”

Section: Diagnosis Of Neurosyphilismentioning

confidence: 99%

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Wu,

Ye,

Wang

et al. 2024

Front. Neurol.

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Background and aimInvasion of the central nervous system by Treponema pallidum can occur at any stage of syphilis. In the event that T. pallidum is not cleared promptly, certain individuals may experience progression to neurosyphilis, which manifests as cognitive and behavioral abnormalities, limb paralysis, and potentially fatal outcomes. Early identification or prevention of neurosyphilis is therefore crucial. The aim of this paper is to conduct a critical and narrative review of the latest information focusing exclusively to the pathogenesis and clinical management of neurosyphilis.MethodologyTo compile this review, we have conducted electronic literature searches from the PubMed database relating to neurosyphilis. Priority was given to studies published from the past 10 years (from 2013 to 2023) and other studies if they were of significant importance (from 1985 to 2012), including whole genome sequencing results, cell structure of T. pallidum, history of genotyping, and other related topics. These studies are classic or reflect a developmental process.ResultsNeurosyphilis has garnered global attention, yet susceptibility to and the pathogenesis of this condition remain under investigation. Cerebrospinal fluid examination plays an important role in the diagnosis of neurosyphilis, but lacks the gold standard. Intravenous aqueous crystalline penicillin G continues to be the recommended therapeutic approach for neurosyphilis. Considering its sustained prominence, it is imperative to develop novel public health tactics in order to manage the resurgence of neurosyphilis.ConclusionThis review gives an updated narrative description of neurosyphilis with special emphasis on its pathogenesis, susceptibility, diagnosis, treatment, and prevention.

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Section: Diagnosis Of Neurosyphilismentioning

confidence: 99%

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Wu,

Ye,

Wang

et al. 2024

Front. Neurol.

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“…Various guidelines have contradictions regarding the identification of clinical symptoms of neurosyphilis, the timing of lumbar puncture and the diagnostic criteria of treponemal and nontreponemal detections in CSF. 12 Therefore, specific biomarkers and new diagnostic methods for neurosyphilis are a hot spot in clinical laboratory research.…”

Section: Introductionmentioning

confidence: 99%

Serum Interleukin-26 is a Potential Biomarker for the Differential Diagnosis of Neurosyphilis and Syphilis at Other Stages

Shen¹,

Dong²,

Liu³

et al. 2022

IDR

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Background Interleukin-26 (IL-26) is an atypical proinflammatory cytokine due to its binding to circulating double-stranded DNA and direct antibacterial activity. Although IL-26 has been confirmed to be involved in the pathophysiology of cancer, chronic inflammatory diseases and infections, the diagnostic and prognostic values of IL-26 levels in syphilis patients are not clear. This study aimed to investigate IL-26 levels in different stages of syphilis progression. Methods A total of 30 healthy controls and 166 patients with syphilis at different stages of disease progression were enrolled. Serum IL-26 levels were quantified in accordance with the protocols of RayBio ® Human Interleukin-26 Enzyme Linked Immunosorbent Assay (ELISA) kits. Clinical laboratory diagnostic parameters and blood analysis data were detected and collected according to clinical medical laboratory standards. Results The levels of serum IL-26 were significantly higher in neurosyphilis patients than in healthy subjects (6.87 (4.36, 12.14) and 1.67 (0.09, 4.89) pg/μL, respectively; ****p < 0.0001), latent syphilis (1.48 (0.40, 2.05) pg/μL, ****p < 0.0001), seroresistant syphilis (0.81 (0.20, 2.91) pg/μL, ****p < 0.0001) and secondary syphilis (1.66 (0.41, 4.25) pg/μL, ****p < 0.0001) with data presented as the median with interquartile range. The concentration of serum IL-26 was most sensitive to serum low-density lipoprotein concentration (r = −0.438, **p = 0.004) in latent syphilis, urine epithelial cells (r = 0.459, **p = 0.003) in seroresistant syphilis, and serum creatinine levels (r = 0.463, **p = 0.004) and urea creatinine ratio levels (r = 0.500, **p = 0.008) in secondary syphilis patients. There was no significant correlation with the concentration of IL-26 and toluidine red unheated serum test (TRUST) titers in each type of syphilis patient. Conclusion Circulating IL-26 in serum displays diagnostic potential in the progression of neurosyphilis and warrants further evaluation in clinical trials.

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Syphilitic Meningoencephalitis Presenting as Status Epilepticus in a Patient With HIV

Irizarry-Caro,

Egge,

Alsheikh-Kassim

et al. 2023

AIM Clinical Cases

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Status epilepticus with focal neurologic deficits: a rare presentation of Neurosyphilis

Cited by 3 publications

References 10 publications

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Serum Interleukin-26 is a Potential Biomarker for the Differential Diagnosis of Neurosyphilis and Syphilis at Other Stages

Syphilitic Meningoencephalitis Presenting as Status Epilepticus in a Patient With HIV

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