Syphilitic Infections

The incidence of infection with the spirochete Trepo-nema pallidum is rising among individuals infected with HIV and in those who abuse illicit substances.

The disease is acquired by venereal contact. In about 40% of cases, the spirochetes infect the nervous system via the bloodstream within several weeks to several months after the initial infection and produce a menin-geal reaction. This may remain clinically asymptomatic and is diagnosed only by a positive serology test of the CSF.

Neurosyphilis may manifest clinically from 1 year to as long as 15 to 20 years after the initial infection. It presents under several forms, depending on the site of involvement: meninges, blood vessels, or parenchyma of the brain and spinal cord. The diagnosis is confirmed by examination of the CSF, which shows mild to moderate pleocytosis with lymphocytes and plasma cells, moderately increased protein and IgG immunoglobulin, and a positive serology for syphilis.

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