Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep 5;4(9):000718.
doi: 10.12890/2017_000718. eCollection 2017.

Neurosyphilis Presenting with Papillitis

Martin Edward Perry  1 , Sarah Cooper  2 , Shona Corry  2
Affiliations

Neurosyphilis Presenting with Papillitis

Martin Edward Perry et al. Eur J Case Rep Intern Med. .

Abstract

Syphilis is one of the oldest described infectious diseases in the world and is caused by the spirochete bacterium Treponema pallidum [1]. Although now a rare disease, incidence is increasing with the number of diagnoses of the disease rising in England from 1688 to 2713 between 2003 and 2012 (a 61% increase)[2]. Major outbreaks of syphilis have been documented in London, Manchester, Dublin, and Brighton particularly among men who have sex with men (MSM)[3]. Diagnosis remains difficult on account of multi-system symptoms, duration of the condition, and social stigma.

Learning points: Normal CSF pressure with indistinct optic disc margins suggests papillitis, not papilloedemaNeurosyphilis can cause various ocular symptoms and is a cause of unexplained high ESRWhen treating with penicillin, the physician should be aware of a potential Jarish-Herzheimer reaction.

Keywords: Neurosyphilis; Treponema pallidum; papillitis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
Indistinct optic disc margins but normal CSF opening pressure in papillitis
See this image and copyright information in PMC

References

    1. Centres for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines – Syphilis. 2015. [accessed 30/05/2017]. Available from: https://www.cdc.gov/std/tg2015/syphilis.htm.
    1. Public Health England. Infectious Syphilis and Congenital Syphilis: Recent Epidemiology. [accessed 30/05/2017]. Available from: https://www.gov.uk/government/publications/infectious-syphilis-and-conge....
    1. West of Scotland Sexual Health Managed Clinical Network. West of Scotland Syphilis Protocol. [accessed 30/05/2017]. Available from: http://www.sandyford.org/media/3028/west-of-scotland-syphilis-protocol-c....
    1. Mehrabian S, Raycheva M, Traykova M, Stankova M, Penev L, et al. Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging. [accessed 30/05/2017];BMC Neurol. 2012 96 Available from: https://bmcneurol.biomedcentral.com/articles/10.1186/1471-2377-12-96. - DOI - PMC - PubMed
    1. Kingston M, et al. UK National Guidelines on the Management of Syphilis 2015. Int J STD AIDS. 2015;0:1–26. doi: 10.1177/0956462415624059. (NICE accredited) (NICE accredited) - DOI - PubMed

LinkOut - more resources