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Syphilitic aseptic meningitis

Meningitis - syphilitic; Neurosyphilis - syphilitic meningitis

Syphilitic aseptic meningitis, or syphilitic meningitis, is a complication of untreated syphilis. It involves inflammation of the tissues covering the brain and spinal cord.

Causes

Syphilitic meningitis is a form of neurosyphilis. This condition is a life-threatening complication of syphilis infection. Syphilis is a sexually transmitted infection.

Syphilitic meningitis is similar to meningitis caused by other germs (organisms).

Risks for syphilitic meningitis include a past infection with syphilis or other sexually transmitted illnesses such as gonorrhea. Syphilis infections are mainly spread through sex with an infected person. Sometimes, they may be passed by nonsexual contact.

Symptoms

Symptoms of syphilitic meningitis may include:

Exams and Tests

The health care provider will perform a physical exam. This may show problems with the nerves, including nerves that control eye movement.

Tests may include:

If screening tests show a syphilis infection, more tests are done to confirm the diagnosis. Tests include:

Treatment

The goals of treatment are to cure the infection and stop symptoms from getting worse. Treating the infection helps prevent new nerve damage and may reduce symptoms. Treatment does not reverse existing damage.

Medicines likely to be given include:

  • Penicillin or other antibiotics (such as tetracycline or erythromycin) for a long time to make sure the infection goes away
  • Medicines for seizures

Outlook (Prognosis)

Some people may need help eating, dressing, and caring for themselves. Confusion and other mental changes may either improve or continue long-term after antibiotic treatment.

Late-stage syphilis can cause nerve or heart damage. This can lead to disability and death.

Possible Complications

Complications may include:

  • Inability to care for self
  • Inability to communicate or interact
  • Seizures that may result in injury
  • Stroke

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have seizures.

Call your provider if you have a severe headache with fever or other symptoms, especially if you have a history of syphilis infection.

Prevention

Proper treatment and follow-up of syphilis infections will reduce the risk of developing this type of meningitis.

If you are sexually active, practice safer sex and always use condoms.

All pregnant women should be screened for syphilis.

References

Radolf JD, Tramont EC, Salazar JC. Syphilis (Treponema pallidum). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 239.

Tunkel AR, van de Beek D, Scheld WM. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 89.

    • Central nervous system and peripheral nervous system

      Central nervous system and peripheral nervous system - illustration

      The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

      Central nervous system and peripheral nervous system

      illustration

    • Primary syphilis

      Primary syphilis - illustration

      Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Primary syphilis presents as a small painless open sore 3 to 6 weeks after exposure. Although the lesion heals within 6 to 8 weeks, the untreated organism will continue to multiply unchecked, causing many complications. Infection may last for 30 years or more and result in severe neurological complications.

      Primary syphilis

      illustration

    • Syphilis - secondary on the palms

      Syphilis - secondary on the palms - illustration

      Secondary syphilis is one of the few infectious diseases that produces rashes on the palms and soles, as well as a generalized rash. If an ulcer on the penis is followed several weeks later by a rash, the person should always be evaluated for syphilis.

      Syphilis - secondary on the palms

      illustration

    • Late-stage syphilis

      Late-stage syphilis - illustration

      Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.

      Late-stage syphilis

      illustration

      • Central nervous system and peripheral nervous system

        Central nervous system and peripheral nervous system - illustration

        The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

        Central nervous system and peripheral nervous system

        illustration

      • Primary syphilis

        Primary syphilis - illustration

        Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Primary syphilis presents as a small painless open sore 3 to 6 weeks after exposure. Although the lesion heals within 6 to 8 weeks, the untreated organism will continue to multiply unchecked, causing many complications. Infection may last for 30 years or more and result in severe neurological complications.

        Primary syphilis

        illustration

      • Syphilis - secondary on the palms

        Syphilis - secondary on the palms - illustration

        Secondary syphilis is one of the few infectious diseases that produces rashes on the palms and soles, as well as a generalized rash. If an ulcer on the penis is followed several weeks later by a rash, the person should always be evaluated for syphilis.

        Syphilis - secondary on the palms

        illustration

      • Late-stage syphilis

        Late-stage syphilis - illustration

        Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.

        Late-stage syphilis

        illustration

      Review Date: 9/22/2018

      Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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