Neurosyphilis

Excerpt

Syphilis is an infectious disease caused by the spirochete bacteria Treponema pallidum (T pallidum). It has been called the "great imitator" due to the multitude of symptoms it produces. The diagnosis becomes further muddled by periods of active disease and latency. The term neurosyphilis refers to an infection involving the central nervous system (CNS). Unlike primary, secondary, and tertiary syphilis, neurosyphilis can occur at any time after infection. Studies have shown that T pallidum may be present in the cerebral spinal fluid (CSF) within hours of initial infection. Bacterial neuroinvasion occurs early in all infected patients, and a failure of clearance results in the clinical manifestations of neurosyphilis.

Five types of neurosyphilis exist, which range from the early forms—consisting of asymptomatic and meningeal (presenting <1 year from infection)—to meningovascular (presenting at 5 to 12 years)—to the late or tertiary forms—general syphilitic paresis and tabes dorsalis (presenting at >10 years from infection). The latter can occur decades after the initial inoculation. Ocular and auditory symptoms may also occur at any stage of infection and are considered forms of neurosyphilis.