Study On The Clinical Characteristics Of 35 Cases Of Neurosyphilis

Background:Syphilis is cadaverous helicoid(Treponema pallidum,TP)infection caused by a chronic disseminated,sexually transmitted diseases,and is the only source of infection.Pale helicoid easily through the damaged skin and mucous membrane invades the human body to survive and reproduce,almost involving all of the body tissues and organs,and produce the complexity and diversity of symptoms and signs,cause multi system damage,and even a threat to life.No portion of the central nervous system is immune to the ravages of syphilis.Infection by Treponema pallidum can affect the meninges,brain,brainstem,spinal cord,nerve roots,and cerebral and spinal blood vessels.As a consequence,the disease may present in diverse and,at times,diagnostically challenging fashions.Neurologic manifestations of syphilis may develop within months of the initial infection or,alternatively,take decades to appear The features of neurosyphilis may be modified by the concomitant presence of immunosuppressive agents or conditions such as HIV/AIDS.The epidemiology ofneurosyphilis has largely paralleled that of syphilis in general.A dramatic decline occurred by the early 1950 s as a consequence of public health measures and the widespread use of antibiotics.The incidence had increased by the onset of the AIDS pandemic.Objective:Through the analysis of neurosyphilis,improve the clinical diagnosis of the disease,early standardized treatment.Methods: Statistical Department of Dalian Medical University from January2006 to 31 December 1,to 2015 discharge diagnosis for cases of neurosyphilis wereretrospectively studied.Analysis of these patients in general,clinical symptoms,laboratory examination,image examination.t.Result:Of the 35 patients,27 were male(77%),and 8 were female(23%).Inform the doctor who had syphilis contact history or excursion history of 15,accounting for42% of the20 people,have not been accounted for 58%.Age 27~77 years old,average age 48 years old.4 cases of meningeal syphilis,much companion has calorific,have a headache;10 cases of meningovascular syphilis,speech disorder,limb weakness,etc.;paralytic dementia in 13 cases,common memory loss,mental disorders,;tabes dorsalis(3 cases),often accompanied by numbness of the limbs,two obstacles,deep sleep obstacle;gummatous syphilis 1 case,accompanied by headache,weakness in the limbs;4 cases of non classical types of neurosyphilis,two classical types of neurosyphilis type combination.35 cases of patients with serum syphilis test were positive,RPR of cerebrospinal fluid between 1:1~1:32 positive,the cerebrospinal fluid VDRL between1:4~1:8 positive.Imaging showed multiple ischemic lesions and cerebral atrophy in frontal lobe,temporal lobe,and other single or multiple lesions.In 35 patients,the misdiagnosis in 17 cases,accounted for 48%,misdiagnosis: 5 cases of cerebral infarction;Misdiagnosis 3 cases of meningitis;Misdiagnosis for mental disorders and Alzheimer's disease in 2 cases;Misdiagnosis for spinal cord inflammation,epilepsy,oculomotor nerve palsy,hydrocephalus,Parkinson's disease in 1 case respectively.Conclusion:Neurosyphilis clinical manifestations varied,the most critical examination of cerebrospinal fluid is the diagnosis of neurosyphilis,but no a check or clinical symptoms can confirm the diagnosis of neurosyphilis,must be combined with patient history,clinical symptoms and the inspection diagnosis.2.Neurosyphilis misdiagnosed rate is extremely high,performance for mental symptoms,when encountered no reason for the psychiatric symptoms,dementia should be highly vigilant of neurosyphilis.