Authors: D. Vaňousová, R. Černý, H. Zákoucká, P. Kožner, D. Jilich, J. Lisý, J. Hercogová, L. Machala
Authors - sphere of activity: 1Dermatovenerologická klinika 2. LF UK a Nemocnice Na Bulovce, Praha; 2Neurologická klinika dospělých 2. LF UK a FN v Motole, Praha; 3Národní referenční laboratoř pro syfilis, Státní zdravotní ústav, Praha; 4Oční oddělení, Nemocnice Na Bulovce, Praha; 5Klinika infekčních a tropických nemocí 1. LF UK a Nemocnice Na Bulovce, Praha; 6Klinika zobrazovacích metod 2. LF UK a FN v Motole, Praha; 7Klinika infekčních nemocí 3. LF UK a Nemocnice Na Bulovce, Praha
Article: Cesk Slov Neurol N 2012; 75/108(3): 297-302
Category: Review Article
Number of articles displayed: 449x
Syphilis is an old disease and its incidence in developed countries decreased in the second half of the last century. However, at present, syphilis is on increase again. Since 1990, when the incidence was lowest, the incidence of syphilis in the Czech Republic increased more than six-fold with HIV+ homosexual men and drug addicts being the highest risk groups. The CNS can be involved at any stage of syphilis; early forms of neurosyphilis currently predominate, whereas late complications rarely occur. The diagnosis of syphilis is based on serological tests. A combination of both nonspecific (nontreponemal) and specific (treponemal) methods are used for screening; specific tests are used for confirmation. Clinical symptomatology of neurosyphilis is very variable and comprehensive analysis of cerebrospinal fluid including specific and nonspecific serologic tests plays a crucial role in diagnostics. Legislation requires all cases of diagnosed syphilis to be reported and treated. Neurosyphilis is treated with benzylpenicillin as a standard, other antibiotics are less effective. After completing the therapy, all patients are followed up long-term by a venereologist. Considering the complex clinical and laboratory symptomatology of neurosyphilis, correct diagnosis and optimal therapeutic decision requires close cooperation between a neurologist, venereologist and laboratory specialist.
syphilis – neurosyphilis – diagnosis – therapy
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