Meningeal syphilis

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Meningeal syphilis
Treponema pallidum 01
SpecialtyInfectious diseases Edit this on Wikidata

Meningeal syphilis (as known as syphilitic aseptic meningitis or meningeal neurosyphilis) is a chronic form of

spirochate bacterium, is the main cause of syphilis, which spreads drastically throughout the body and can infect all its systems if not treated appropriately. Treponema pallidum is the main cause of the onset of meningeal syphilis and other treponemal diseases, and it consists of a cytoplasmic and outer membrane that can cause a diverse array of diseases in the central nervous system and brain.[1]

Early symptomatic neurosyphilis (or acute syphilitic meningitis or neurorecurrence) is the onset of meningeal syphilis. The symptoms arise as a result of inflamed meninges, which eventually lead up to signs of meningitis.[2]

Treponema pallidum invades the

meningovascular syphilis, which is usually presented during the secondary stage of syphilis. If syphilis is prolonged, it can affect the nervous system, which is known as neurosyphilis.[4]
Meningeal syphilis is a component of neurosyphilis, which usually occurs in the tertiary stage of syphilis.

Signs and symptoms

Syphilis lesions on back
Syphilis lesions on back

Asymptomatic

General symptoms of meningeal syphilis

  • symptoms of meningitis can occur at any time after the infection
  • however, it usually appears within two years
  • symptoms may include headache, stiff neck, cranial nerve palsies,
    convulsions
    , and mental confusion
  • patient is
    afebrile[1]

General symptoms of neurosyphilis

General signs of neurosyphilis

Argyll Robertson Pupil constriction

Clinical features

The types of neurosyphilis include asymptomatic, acute syphilitic meningitis, meningovascular syphilis, parenchymatous syphilis (which includes general paresis and tabes dorsalis), and optic atrophy.[5]

Anatomy of disease

Brain with meningitis

endothelial cells that line the brain capillaries. Only certain water-soluble substances can move across the blood–brain barrier, while lipid-soluble substances can easily move across the blood–brain barrier. However, when any form of bacteria gets through to the blood–brain barrier, a bacterial infection can result in the cerebrospinal fluid.[6]

This fluid circulates through the brain and spinal cord, and it is produced in the

choroid plexuses. The meninges consists of three connective tissues that cover the spinal cord and brain. They are lined with vertebral cavities, which is used as protection for the central nervous system. When the cerebrospinal fluid is infected, the meninges become inflamed and can start to deteriorate. This inflammation of the membranes causes meningitis.[7]

Pathophysiology

Autopsy of brain with meningitis

lipids. Their axial filaments consists of endoflagella and periplasmic flagella. The creatures cannot be cultured in lab, and they are an obligate pathogen. Humans are the only host for this bacteria, and the bacteria can get through the body by minute abrasions of the skin or mucous membranes. The reservoir is in the human genital tract, and its transmission is transmitted sexually or across the placenta.[9]

Stages of disease

The four main stages of syphilis are the primary, secondary, latent, and tertiary stages:

Primary stage

The first sign of syphilis can occur during the first few weeks of exposure. This exposure in particular is caused by the

fluorescent microscopy of lesion; however, fifty percent of patients will be negative by nonspecific serology. If the infected individual does not treat the infection properly, the syphilis can progress to the secondary stage.[citation needed
]

Secondary stage

Secondary syphilis-palmar rash

The secondary stages of syphilis persists to be more dangerous to the systems of the human body. The disseminated disease can cause

internal organs.[2] Also common with stage one, the symptoms and signs of secondary syphilis will go away with or without treatment and medication. The diagnosis includes serology nonspecific and specific, both positive. The secondary stage is however highly infectious because the bacteria is spreading drastically throughout the body.[citation needed
]

Latent stage

The latent stage is the asymptomatic stage, which includes two phases. The two phases of the asymptomatic stage include early (within one year of exposure and infection) and late(after one year of exposure and infection). In this stage, the bacteria can remain inactive for three to thirty years, and it may not progress to the tertiary stage of syphilis, which is the final stage. This stage is highly dangerous because the symptoms altogether disappear and remain hidden for a prolonged period of time. The diagnosis of this stage is positive serology.[10] Because the bacteria remains inactive, the late latent syphilis does not spread and is noninfectious.[citation needed]

Tertiary stage

The tertiary stage is known as the final stage of syphilis or "late" syphilis. This deadly stage starts after three years of exposure and infection to syphilis. Typically, the person is no longer contagious with the disease, but the gram-negative bacteria in the body can reactivate, reproduce, multiply, and spread drastically throughout the body. At this point, the infection spreads to all the systems in the human body, including the nervous system, bones, eyes, and heart. Neurosyphilis at this point can cause several damages to the body, including

tumors, and lead to cancerous effects in the body. This stage can be diagnosed through specific tests in serology. The nonspecific tests may be negative. At this point, there is little treatment the individual can pursue, and the body shuts down as a whole.[citation needed
]

Diagnosis

Treponema pallidum

There are several methods to diagnose meningeal syphilis. One of the most common ways include visualizing the

Rapid Plasma Reagin). The Treponemal antibody test (specific test) confirms with FTA-ABS (Fluorescent treponemal antibody-absorption).[13] Brain imaging and MRI scans may be used when diagnosing patients; however, they do not prove to be as effective as specific tests. Specific tests for treponemal antibody are typically more expensive because the earliest antibodies bind to spirochetes. These tests are usually more specific and remain positive in patients with other treponemal diseases.[12]

Cerebrospinal fluid (CSF) findings

Prevention

There are many different forms on prevention of syphilis and other

condoms can however reduce the risk of obtaining syphilis. In order to prevent further contamination to other individuals, benzathine penicillin is given to any contacts. Washing, douching, or urinating cannot prevent the transmission of a sexually transmitted infection in general.[14]
Individuals obtain syphilis through a variety of circumstances. In general, syphilis can be transmitted from individual to individual through direct contact with sores that are present on the external genitals, vagina, rectum, anus, lips, or mouth. Transmission can occur through any form of sexual contact, including vaginal, anal, oral, and manual sex. In addition, women who are pregnant and infected with syphilis can transmit the disease onto their child as well.[3] If transmission has occurred, it is important to check up immediately with a physician to avoid further damage.[citation needed]

Treatment

The penicillin backbone, with variable group highlighted

Penicillin

The most popular treatment forms for any type of syphilis uses penicillins, which have been effective treatments used since the 1940s.[15] Other forms also include

penicillin G is used for late syphilis.[citation needed
]

Jarisch-herxheimer reaction

The

Jarisch-Herxheimer reaction, which is the response to the body after endotoxins are released by the death of harmful organisms in the human body, starts usually during the first day of antibiotic treatment.[16] The reaction increases the person's body temperature, decreases the overall blood pressure (both systolic and diastolic levels), and results in leukopenia and rigors in the body. This reaction can occur during any treatment of spirochete diseases.[citation needed
]

It is important to realize that syphilis can recur. An individual who has had the disease once, even if it has been treated, does not prevent the person from experiencing recurrence of syphilis. Individuals can be re-infected, and because syphilis sores can be hidden, it may not be obvious that the individual is infected with syphilis. In these cases, it is vital to become tested and treated immediately to reduce spread of the infection.[citation needed]

References

  1. ^
    PMID 20626434
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  2. ^
    PMID 15090587
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  3. ^ a b Sutton, K (2013). "Risk Factors". Neil S. Skolnik Amy Lynn Clouse. 17.
  4. S2CID 20028978
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  5. PMID 1549153
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  6. PMID 9395430
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  7. PMID 23083311
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  8. PMID 23545658
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  9. PMID 11014025
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  10. S2CID 22914253
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  11. S2CID 43914799
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  12. ^
    doi:10.1136/sextrans-2013-051184.1123
    .
  13. S2CID 19931104
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  14. ISSN 0894-3257
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  15. PMID 23042973
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  16. PMID 20825309
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