Neurosyphilis presenting with myelitis-case series and literature review |
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| Affiliation: | 1. Departamento de Enfermedades Infecciosas, Hospital de Infectología, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;2. Departamento de Microbiología, Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, IPN, Mexico City, Mexico;3. Centro de Simulación Médica, Facultad Mexicana de Medicina, Universidad La Salle, Mexico City, Mexico;4. Laboratorio Central de Epidemiología, División de Laboratorios de Vigilancia e Investigación Epidemiológica, CMN “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;5. Unidad de Investigación en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;6. Departamento de Patología Clínica, Banco Central de Sangre, CMN “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;7. Laboratorio de Urgencias, Hospital de Infectología, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;8. Center for HIV and Hepatogastroenterology, Duesseldorf, Germany;1. Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, School of Medicine, University of Crete, 71110 Voutes, Heraklion, Crete, Greece;2. Department of Clinical Microbiology, University Hospital of Heraklion, School of Medicine, University of Crete, 71110 Voutes, Heraklion, Crete, Greece;3. National Reference Laboratory for Staphylococci, Department of Microbiology, School of Medicine, University of Patras, Patras, Greece;1. Infection Control Division, South Miyagi Medical Center, Aza-Nishi 38-1, Ogawara, Shibata-gun, Miyagi 989-1253, Japan;2. Department of Emergency and Critical Care Medicine, South Miyagi Medical Center, Aza-Nishi 38-1, Ogawara, Shibata-gun, Miyagi 989-1253, Japan;1. Eiju General Hospital, Taito-ku, Tokyo 110-8645, Japan;2. Kawasaki City Institute for Public Health, Kawasaki, Kanagawa 210-0834, Japan;3. Zama Children''s Clinic, Zama, Kanagawa 252-0023, Japan;4. Ichikawa Children''s Clinic, Isehara, Kanagawa 259-1133, Japan;5. Abe Children''s Clinic, Yokohama, Kanagawa, 223-0051, Japan;6. Yasumi Hospital, Morioka, Iwate 028-4125, Japan;7. Ichikawa Clinic, Fukushima-shi, Fukushima 960-0112, Japan;8. Futaba Children''s Clinic, Ushiku, Ibaraki 300-1207, Japan;9. Junseikai Yoshihara Clinic, Takasaki, Gunma 370-3524, Japan;10. Shiozaki Clinic, Wakayama, Wakayama 640-8482, Japan;11. Wakaayukai Baba Clinic, Nagaokakyou, Kyoto 617-0814, Japan;12. Kudo Clinic, Kakogawa, Hyogo 675-0018, Japan;13. Maebashi Kita Hospital, Maebashi, Gunma 371-0054, Japan;14. Jinjikai Takahashi Clinic, Bando, Ibaraki 306-0631, Japan;15. Yokohama City Institute of Public Health, Yokohama, Kanagawa 236-0051, Japan;1. Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan;2. Department of General Internal Medicine, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan;3. Department of Pediatrics, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan;1. Department of Pharmacy, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, Oita, 874-0011, Japan;2. Center for Pharmacist Education, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi, Chiba, 274-8555, Japan;3. Department of Pharmacy, National Hospital Organization Kyushu Medical Center, 1–8–1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan;4. Department of Medical Pharmaceutics, Faculty of Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama City, Toyama, 930-0194, Japan;5. Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama City, Toyama, 930-0194, Japan |
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| Abstract: | Syphilitic myelitis is an extremely rare manifestation of neurosyphilis and often misdiagnosed. However, a small amount of literature describe its clinical manifestations and neuroimaging features, and there is no relevant data on the prognosis, especially the long follow-up prognosis. In this paper, four syphilitic myelitis patients admitted to our hospital between July 2012 and July 2017 were retrospectively reviewed. Of the four patients, two females and two males. Treatment included intravenous penicillin G, with 24 million units of penicillin G per day administered intravenously for 14 days. Three patients were also treated with corticosteroids. The prognosis were well in three cases who received early anti-syphilis treatment, but one case who received delayed treatment due to misdiagnosis had no improvement. Neurosyphilis should be considered when there is long-segment myelopathy. Anti-treponemal antibiotics and corticosteroid therapy may improve neurological prognosis. |
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| Keywords: | Syphilis Neurosyphilis Magnetic resonance imaging |
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