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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

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
Ocular syphilis.
Tsan GL, Claiborne RT
Clin Exp Optom 2021 Sep;104(7):756-759. Epub 2021 Apr 8 doi: 10.1080/08164622.2021.1906848. PMID: 33831337
Syphilis.
Hook EW 3rd
Lancet 2017 Apr 15;389(10078):1550-1557. Epub 2016 Dec 18 doi: 10.1016/S0140-6736(16)32411-4. PMID: 27993382
Neurosyphilis.
Marra CM
Curr Neurol Neurosci Rep 2004 Nov;4(6):435-40. doi: 10.1007/s11910-004-0065-x. PMID: 15509443
Neurosyphilis.
Scheck DN, Hook EW 3rd
Infect Dis Clin North Am 1994 Dec;8(4):769-95. PMID: 7890932

Diagnosis

Neurosyphilis.
Chow F
Continuum (Minneap Minn) 2021 Aug 1;27(4):1018-1039. doi: 10.1212/CON.0000000000000982. PMID: 34623102
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
Neurosyphilis in patients with HIV.
Hobbs E, Vera JH, Marks M, Barritt AW, Ridha BH, Lawrence D
Pract Neurol 2018 Jun;18(3):211-218. Epub 2018 Feb 24 doi: 10.1136/practneurol-2017-001754. PMID: 29478035
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

Therapy

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
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

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

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
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
Clinical prediction and diagnosis of neurosyphilis in HIV-negative patients: a case-control study.
Lu Y, Ke W, Yang L, Wang Z, Lv P, Gu J, Hao C, Li J, Cai Y, Gu M, Liu H, Chen W, Zhang X, Wang L, Liu Y, Yang B, Zou H, Zheng H
BMC Infect Dis 2019 Dec 2;19(1):1017. doi: 10.1186/s12879-019-4582-2. PMID: 31791265Free PMC Article
Retrospective review of tertiary and neurosyphilis cases in Alberta, 1973-2017.
Landry T, Smyczek P, Cooper R, Gratrix J, Bertholet L, Read R, Romanowski B, Singh AE
BMJ Open 2019 Jun 22;9(6):e025995. doi: 10.1136/bmjopen-2018-025995. PMID: 31230001Free PMC Article
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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