Skip to main content

Neurosyphilis

Gloria J. Klapstein, PhD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A chronic, systemic, infectious disease with any involvement of the CNS at any stage of syphilitic Treponema pallidum infection (primary, secondary, tertiary, and latent)

  • Transmitted ...

DIAGNOSIS

HISTORY

Previous sexual contact with partner with known infection, or partner with high-risk sexual behavior, maternal transmission 

PHYSICAL EXAM

  • Many neurosyphilitic patients are asymptomatic...

TREATMENT

GENERAL MEASURES

All patients with neurosyphilis should be tested for HIV. 

MEDICATION

First Line

Aqueous crystalline penicillin G 18 to 24 million U/day, administered as 3 to 4 million U IV q4h...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • T. pallidum cannot be grown in the laboratory, and there is no microbiologic test of cure.

  • Neurologic and CSF examination at 3 to 6 months and ev...

REFERENCES

1
Boog GHP, Lopes JVZ, Mahler JV, et al. Diagnostic tools for neurosyphilis: a systematic review. BMC Infect Dis. 2021;21(1):568. doi:10.1186/s12879-021-06264-8
2
Workowski KA, Berman S; Cente...

ADDITIONAL READING

  • Berger  JR, Dean  D. Neurosyphilis. Handb Clin Neurol.  2014; 121: 1461– 1472.

  • Ghanem  KG. REVIEW:...

CODES

ICD10

  • A52.3 Neurosyphilis, unspecified

  • A52.2 Asymptomatic neurosyphilis

  • A52.13 Late syphilitic meningitis

  • A52.11 Tabes dorsalis

  • A52.14 Late syphilitic encephalitis

  • A52.17 General paresis

  • A52.10 Symptom...

CLINICAL PEARLS

  • CNS involvement can occur at any stage of syphilis infection.

  • Procaine penicillin is the gold standard for treatment. Penicillin G benzathine does not reach detectable levels in the CSF...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×