scholarly journals Neurosyphilis: An Unresolved Case of Meningitis

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Shagufta Ahsan ◽  
Joesph Burrascano
Keyword(s):  
Skin Rash ◽  
Population Based ◽  
Secondary Syphilis ◽  
Cns Infection ◽  
Disseminated Infection ◽  
Penicillin Therapy

Neurosyphilis can cause both symptomatic and asymptomatic meningitis. However the epidemiology of modern neurosyphilis is not well defined because of the paucity of population-based data. The majority of neurosyphilis cases have been reported in HIV-infected patients. Here we present a case of early neurosyphilis/symptomatic syphilitic meningitis in a non-HIV patient who presented with rash but was mistakenly treated for early latent or secondary syphilis. Syphilis presenting with a skin rash and an extremely high RPR titer could indicate CNS infection rather than simply secondary syphilis because rash is a nonspecific manifestation of disseminated infection. Given the effectiveness of penicillin therapy, why is the rate of syphilis continuing to increase? Is it due to a failure of prevention or could it be also because of failure to diagnose and treat syphilis adequately, as in this case?

scholarly journals Central Nervous System Infection with Other Endemic Mycoses: Rare Manifestation of Blastomycosis, Paracoccidioidomycosis, Talaromycosis, and Sporotrichosis

2019 ◽  
Vol 5 (3) ◽  
pp. 64 ◽  
Author(s):  
Carol A. Kauffman
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hiv Infection ◽  
Acute Infection ◽  
Cns Infection ◽  
Dimorphic Fungus ◽  
Chronic Meningitis ◽  
Disseminated Infection ◽  
Almost All ◽  
Endemic Mycoses

The central nervous system (CNS) is not a major organ involved with infections caused by the endemic mycoses, with the possible exception of meningitis caused by Coccidioides species. When CNS infection does occur, the manifestations vary among the different endemic mycoses; mass-like lesions or diffuse meningeal involvement can occur, and isolated chronic meningitis, as well as widely disseminated acute infection that includes the CNS, are described. This review includes CNS infection caused by Blastomyces dermatitidis, Paracoccidioides brasiliensis, Talaromyces marneffei, and the Sporothrix species complex. The latter is not geographically restricted, in contrast to the classic endemic mycoses, but it is similar in that it is a dimorphic fungus. CNS infection with B. dermatitidis can present as isolated chronic meningitis or a space-occupying lesion usually in immunocompetent hosts, or as one manifestation of widespread disseminated infection in patients who are immunosuppressed. P. brasiliensis more frequently causes mass-like intracerebral lesions than meningitis, and most often CNS disease is part of disseminated infection found primarily in older patients with the chronic form of paracoccidioidomycosis. T. marneffei is the least likely of the endemic mycoses to cause CNS infection. Almost all reported cases have been in patients with advanced HIV infection and almost all have had widespread disseminated infection. Sporotrichosis is known to cause isolated chronic meningitis, primarily in immunocompetent individuals who do not have Sporothrix involvement of other organs. In contrast, CNS infection in patients with advanced HIV infection occurs as part of widespread disseminated infection.

scholarly journals Secondary Syphilis Presenting as Glossodynia, Plaques en Prairie Fauchée, and a Split Papule at the Oral Commissure: Case Report and Review

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Walter de Araujo Eyer-Silva ◽  
Maria Alessandra Leite Freire ◽  
Cecília Angelina Horta-Araujo ◽  
Guilherme Almeida Rosa da Silva ◽  
Jorge Francisco da Cunha Pinto ◽  
...  
Keyword(s):  
Secondary Syphilis ◽  
Oral Lesions ◽  
Review Of The Literature ◽  
Cutaneous Lesions ◽  
Infected Male ◽  
Full Spectrum ◽  
Posterior Aspect ◽  
Complete Clinical Remission ◽  
Penicillin Therapy ◽  
Oral Commissure

Syphilis has been coined “the great imitator” due to its extreme heterogeneity of presentation and mimicry of other conditions. Therefore, it is essential that physicians be familiar with the full spectrum of its manifestations. Syphilis may also lead to oral lesions that, occasionally, are unaccompanied by concomitant tegumentary findings. Such patients will pose unique diagnostic challenges. We report the case of a 45-year-old HIV-infected male patient in whom secondary syphilis presented with burning mouth and dysgeusia that progressed to glossodynia and odynophagia. Examination revealed painful, shallow erosions on the posterior aspect of the tongue, in a pattern of plaques en prairie fauchée. A painful split papule (fausse perlèche or false angular cheilitis) was also present in the left commissure. There were no cutaneous lesions. The oral lesions were considered highly suggestive of secondary syphilis. A novel VDRL assay (which was previously negative) yielded a titer of 1/128. Complete clinical remission was rapidly achieved after initiation of penicillin therapy. A comprehensive review of the literature on oral manifestations of syphilis is offered.

scholarly journals Skin rash, dyspnea and bone pain: secondary syphilis

2015 ◽  
Vol 19 (1) ◽  
pp. 96-97 ◽  
Author(s):  
Juan Manríquez ◽  
Romina Andino-Navarrete ◽  
Catalina Andrighetti
Keyword(s):  
Skin Rash ◽  
Bone Pain ◽  
Secondary Syphilis
Sign in / Sign up

Export Citation Format

Share Document