What is the pathophisiology of syphilis myelitis?
Best insight from top research papers
Syphilitic myelitis is a rare manifestation of neurosyphilis characterized by acute spinal cord infection caused by Treponema pallidum. The pathophysiology involves diffuse demyelinization, vascular changes, and irregular demyelination. Clinical presentation includes flaccid paralysis, loss of sensation, spontaneous spasmodic movements, and urinary issues. MRI findings show diffuse high signal intensity on T2-weighted images and focal enhancement on T1-weighted images. Differential diagnosis includes transverse myelitis, thrombosis of spinal arteries, and other infectious causes. Treatment involves IV penicillin, pulse steroid therapy, and a prolonged prednisone taper for symptom improvement. Syphilitic myelitis can be challenging to diagnose but should be considered in cases of longitudinally extensive myelopathy.
Answers from top 5 papers
More filters
| Papers (5) | Insight |
|---|---|
31 Citations | Syphilitic myelitis likely results from spinal vessel thrombosis due to syphilitic endarteritis, leading to acute paraplegia, sphincter loss, and sensory deficits, as described in the paper. |
| Syphilitic myelitis is a rare spinal cord infection caused by Treponema pallidum. It mainly affects the spinal cord parenchyma, leading to characteristic MRI findings and CSF abnormalities aiding in diagnosis. | |
| Syphilitic myelopathy involves diffuse demyelination and vascular changes in the spinal cord. It differs from syphilitic myelitis, which is usually remittent and develops over months or years. | |
| Syphilitic myelitis in the spinal cord can lead to symptoms like spastic paralysis due to dorsal myelitis of syphilitic origin, often not involving the entire cord's transverse section. | |
| Syphilitic myelitis, a rare neurosyphilis manifestation, involves longitudinally extensive spinal cord lesions. Pathophysiology involves Treponema pallidum invasion leading to cord inflammation, expansion, and neurological deficits. |
Related Questions
Can the transmission of syphilis occur through contact with treated semen?5 answersTransmission of syphilis can occur through various means, including sexual contact, kissing, transfusions, or unintentional injection. Syphilis has different stages, with primary and secondary stages being highly infectious, characterized by lesions like chancres and mucous patches. Studies have shown that asymptomatic infections can still lead to transmission, with uncertainties regarding the exact stage of infectiousness. Semen has been investigated as a potential vehicle for transmission, with early cases showing infectious organisms, especially in secondary syphilis. Safe sexual practices and controlled treatment at all stages, including pregnancy, are crucial in curbing the spread of syphilis. Therefore, even treated semen may still pose a risk of syphilis transmission due to potential asymptomatic infections and the presence of infectious organisms in early cases.
Does the chemotactic molecule responsible for syphilis neurotropism differ between primary and secondary syphilis?5 answersThe chemotactic molecule responsible for syphilis neurotropism does not differ between primary and secondary syphilis. Treponema pallidum, the causative agent of syphilis, utilizes sensory transduction events involving methyl-accepting chemotaxis proteins (MCPs) for motility and tissue invasion. Studies have identified a putative T. pallidum MCP gene (mcp1) encoding a sensory transducer protein highly homologous to other bacterial MCPs, indicating a conserved mechanism across different stages of syphilis. Additionally, neurosyphilis, a complication of syphilis affecting the central nervous system, involves persistent inflammation and tissue damage due to the survival of T. pallidum remnants, promoting chronic inflammation independent of active infection. This suggests that the mechanisms underlying neurotropism and chronic inflammation in neurosyphilis are consistent throughout the course of the disease.
What is the cure of syphilis?4 answersThe primary treatment for syphilis is penicillin G, which remains the preferred choice across all stages of the disease. However, recent studies have explored enhanced treatment regimens involving additional antibiotics like doxycycline and ceftriaxone alongside benzathine penicillin G, showing promising results in terms of higher and faster cure rates, especially in preventing complications like neurosyphilis. Furthermore, alternative medicines using herbal ingredients have also shown efficacy in treating syphilis, with clinical tests reporting high cure rates for both early and late stages of the disease. These findings highlight the importance of timely and appropriate treatment to effectively manage syphilis and prevent long-term complications.
Can syphilis infect after treatment?4 answersYes, syphilis can reinfect individuals even after treatment. Syphilis infection does not confer definitive and protective immunity against reinfection. Studies have shown high rates of treatment failure and reinfection among syphilis patients. Factors such as the stage of syphilis, HIV status, and frequency of condom use have been found to be associated with the serological outcome after treatment. Regular clinical and serologic evaluations after treatment are important to monitor for treatment failure and reinfection. It is particularly crucial to intensify health counseling and safety education on sexual activity among HIV-infected patients and those with secondary syphilis after treatment. Syphilis reinfections are predominantly diagnosed in HIV-positive men who have sex with men (MSM). Therefore, follow-up and monitoring for reinfection are essential in syphilis management.
Enumerate other laboratory test for syphillis?3 answersSerological tests are commonly used for the laboratory diagnosis of syphilis. These tests can be grouped into non-treponemal and treponemal types. Non-treponemal tests include the Venereal Disease Research Laboratory (VDRL) slide test, Unheated Serum Reagin (USR) test, Rapid Plasma Reagin (RPR) test, and Toluidine Red Unheated Serum test (TRUST). Treponemal tests detect treponemal specific antibodies and are available in different assay formats. In recent years, reverse sequence screening algorithms have been developed, using a treponemal assay as the initial screening test. Another laboratory test for syphilis is the Syphilis Health Check (SHC) assay, which is a rapid treponemal test that is simple to perform, accessible, and inexpensive. Molecular analysis with polymerase chain reaction (PCR) is also a promising method for syphilis diagnosis, but standardization is still required.
What's Pathophysiology of herpes?3 answersThe pathophysiology of herpes involves the infection and replication of the herpes simplex virus (HSV) in various tissues and cells of the body. HSV-1 primarily causes orofacial and genital infections, while HSV-2 primarily causes genital infections. In ocular herpes, HSV-1 enters corneal epithelial cells through interactions with cell surface receptors, leading to corneal lesions and potential blindness. The specific patterns of accumulation of porphyrins and their toxic precursors in porphyrias result in a variety of clinical manifestations, including acute neurovisceral attacks, skin lesions, and liver disease. Postherpetic neuralgia (PHN), a complication of herpes, is believed to involve multiple mechanisms operating simultaneously, leading to a constellation of painful sensations and sensory loss. Genital herpes is considered a chronic rather than an intermittent disease, with recurrent shedding of the virus even in the absence of clinical signs.