User:Mr. Ibrahem/Neurosyphilis

Neurosyphilis refers to infection of the central nervous system by syphilis. It can occur at any time after infection. It may occur with no symptoms, or result in meningitis, stroke symptoms, general paresis, or tabes dorsalis. Meningitis presents with headaches, stiff neck, and vomiting. General paresis may result in personality changes, delusions, and tremor. Tabes dorsalis may result in poor coordination, numbness, bladder problems, and abnormal eye movements.

The cause is the bacteria Treponema pallidum. It is more common in those who also have HIV. The diagnosis involves a lumbar puncture to obtain cerebrospinal fluid (CSF) for analysis. If the VDRL test on CSF is positive, this confirms the diagnosis; however, a negative test dose not rule it out. This is sometimes supplemented by fluorescent treponemal antibody absorption testing (FTA-ABS).

Treatment of neurosyphilis is generally with penicillin G at doses of 3 to 4 million units intravenously every four hours for 10 to 14 days. Penicillin may also be given once daily by injection into a muscle together with probenecid by mouth. In those who are allergic to penicillin, ceftriaxone may be used. When treated early outcomes are generally good.

Neurosyphilis is rare, though cases have been increasing. In the United States nearly 2% of people with early syphilis had neurosyphilis. Though in parts of Africa about 2% of the general population may be affected. Males are more commonly affected than females. Before the availability of antibiotics about 30% of those with syphilis had neurosyphilis.