Neurosyphilis

Neurosyphilis is an infection of the central nervous system by Treponema pallidum, the bacterium that causes the sexually transmitted infection syphilis. It can occur at any stage of syphilis infection. Early disease is often without symptoms, and meningitis is the most common early presentation, while late disease tends to involve the brain and spinal cord, appearing as tabes dorsalis and general paresis. Since the arrival of modern antibiotics, most reported cases have been in people who also have HIV. Diagnosis rests on the clinical history, a neurological examination and analysis of cerebrospinal fluid obtained by lumbar puncture, since no single laboratory test confirms every case. The standard treatment is intravenous penicillin G given for 10 to 14 days, and patients are also evaluated for HIV.