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Published on: September 19, 2010
Imaging features of neurosyphilis
Diogo Goulart Corrêa1, Simone Rachid de Souza2, Tomás de Andrade Lourenção Freddi3
1Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ 2640-102, Brazil; Department of Radiology, Federal Fluminense University, Rua Marquês de Paraná, 303, Centro, Niterói, RJ 24070-035, Brazil.
Abstract:
Syphilis is an infectious disease caused by the spirochete Treponema pallidum, subspecies pallidum. Although its incidence has declined after the widespread availability of penicillin, it has recently re-emerged, especially in men who have sex with men and in people living with human immunodeficiency virus (HIV). The neurological manifestations of syphilis, generally known as neurosyphilis, may appear at any time during the infection, including the initial years after the primary infection. Neurosyphilis can be asymptomatic, only with cerebrospinal fluid abnormalities, or symptomatic, characterized by several different clinical syndromes, such as meningitis, gumma, meningovascular, brain parenchyma involvement, meningomyelitis, tabes dorsalis, and peripheral nervous system involvement. However, these syndromes may simulate several other diseases, making the diagnosis often a challenge. In addition, syphilis can also be vertically transmitted from mother to child during pregnancy, leading to neurological manifestations. Neuroimaging is essential to demonstrate abnormal brain or spinal cord findings in patients with neurosyphilis, aiding in the diagnosis, treatment, and follow-up of these patients. This article aims to review the imaging features of neurosyphilis, including the early and late stages of the infection.
Insights
Neurosyphilis, a re-emerging infection caused by Treponema pallidum, presents diverse neurological syndromes. Neuroimaging is crucial for diagnosing and managing this challenging syphilis manifestation.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Syphilis, caused by Treponema pallidum, is re-emerging, particularly in high-risk populations.
- Neurosyphilis, a neurological complication, can manifest with varied clinical syndromes and may mimic other diseases.
- Vertical transmission of syphilis can lead to neurological issues in newborns.
Purpose of the Study:
- To review the neuroimaging features of neurosyphilis.
- To cover both early and late stages of neurosyphilis.
- To highlight the diagnostic role of neuroimaging in neurosyphilis.
Main Methods:
- Review of neurosyphilis literature focusing on imaging findings.
- Analysis of neuroimaging characteristics across different clinical presentations.
- Correlation of imaging findings with disease stages.
Main Results:
- Neurosyphilis presents diverse imaging findings, including meningitis, gumma, meningovascular changes, parenchymal involvement, and spinal cord abnormalities.
- Imaging can detect asymptomatic cerebrospinal fluid abnormalities.
- Neuroimaging aids in differentiating neurosyphilis from other neurological conditions.
Conclusions:
- Neuroimaging is indispensable for the diagnosis, management, and follow-up of neurosyphilis.
- Recognizing imaging patterns is key to timely diagnosis and treatment.
- Early detection through neuroimaging can improve patient outcomes.
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