The difficulties of diagnosis of neurosyphilis at the modern stage

At the modern stage in Russia, we can observe the tendency of increase in recording cases of neurosyphilis against the background of reduction of morbidity rate of syphilitic infection in general. Increase of neurosyphilis morbidity reflects the situation of frequency increase of primary forms of sy...

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Main Authors: T. L. Vizilo, T. V. Poponnikova, I. F. Fedoseeva, E. D. Vasenina
Format: Article
Language:Russian
Published: Open Systems Publication 2021-11-01
Series:Лечащий Врач
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Online Access:https://journal.lvrach.ru/jour/article/view/821
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author T. L. Vizilo
T. V. Poponnikova
I. F. Fedoseeva
E. D. Vasenina
author_facet T. L. Vizilo
T. V. Poponnikova
I. F. Fedoseeva
E. D. Vasenina
author_sort T. L. Vizilo
collection DOAJ
description At the modern stage in Russia, we can observe the tendency of increase in recording cases of neurosyphilis against the background of reduction of morbidity rate of syphilitic infection in general. Increase of neurosyphilis morbidity reflects the situation of frequency increase of primary forms of syphilis in the end of the 90s – beginning of the 2000s, when our country faced with epidemic of this disease. Most experts assume that treponema pallidum always penetrates in the nervous system, in some cases its presence being transitory, in other cases, we observe asymptomatic persistence, and in some, neurosyphilis manifests. Currently, most often syphilis therapy takes place on outpatient basis with repository forms ((Benzathine benzylpenicillins) which create long (during several days and up to 18-21 days after one-time administration), but low concentration of penicillin in the body. These drugs badly overcome blood-brain barrier, consequently, if syphilitic meningitis is latent and not diagnosed, liquor sanation is not achieved, and potential development of neurosyphilis manifest forms is retained. The authors describe the difficulties of diagnosis of neurosyphilis and a clinical case of ischemic stroke in a young patient with neurosyphilis. Diagnosis of syphilis was confirmed by laboratory studies; liquor tests and clinical data allowed to diagnose meningovascular syphilis. The authors highlight that special attention should be paid to observance of algorithm of clinical-laboratory examination of patients if they have disorders in functions of central and peripheral nervous systems, organs of vision and hearing, regardless of remoteness of supposed infection and supposed seroresistance. As neurosyphilis is interdisciplinary problem, complex clinical-laboratory and clinical-instrumental examination of patients is required, involving medical specialists of different profiles.
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spelling doaj-art-8fa90dce7fe5413ea43ebc19e006fecc2025-08-20T02:49:01ZrusOpen Systems PublicationЛечащий Врач1560-51752687-11812021-11-01010283510.51793/OS.2021.24.10.005819The difficulties of diagnosis of neurosyphilis at the modern stageT. L. Vizilo0T. V. Poponnikova1I. F. Fedoseeva2E. D. Vasenina3FSBEI HE Kemerovo State Medical University of the Healthcare Ministry of the Russian FederationFSBEI HE Kemerovo State Medical University of the Healthcare Ministry of the Russian FederationFSBEI HE Kemerovo State Medical University of the Healthcare Ministry of the Russian FederationNovokuznetsk branch of Kemerovo Cardiology Center named after L. S. BarbarashAt the modern stage in Russia, we can observe the tendency of increase in recording cases of neurosyphilis against the background of reduction of morbidity rate of syphilitic infection in general. Increase of neurosyphilis morbidity reflects the situation of frequency increase of primary forms of syphilis in the end of the 90s – beginning of the 2000s, when our country faced with epidemic of this disease. Most experts assume that treponema pallidum always penetrates in the nervous system, in some cases its presence being transitory, in other cases, we observe asymptomatic persistence, and in some, neurosyphilis manifests. Currently, most often syphilis therapy takes place on outpatient basis with repository forms ((Benzathine benzylpenicillins) which create long (during several days and up to 18-21 days after one-time administration), but low concentration of penicillin in the body. These drugs badly overcome blood-brain barrier, consequently, if syphilitic meningitis is latent and not diagnosed, liquor sanation is not achieved, and potential development of neurosyphilis manifest forms is retained. The authors describe the difficulties of diagnosis of neurosyphilis and a clinical case of ischemic stroke in a young patient with neurosyphilis. Diagnosis of syphilis was confirmed by laboratory studies; liquor tests and clinical data allowed to diagnose meningovascular syphilis. The authors highlight that special attention should be paid to observance of algorithm of clinical-laboratory examination of patients if they have disorders in functions of central and peripheral nervous systems, organs of vision and hearing, regardless of remoteness of supposed infection and supposed seroresistance. As neurosyphilis is interdisciplinary problem, complex clinical-laboratory and clinical-instrumental examination of patients is required, involving medical specialists of different profiles.https://journal.lvrach.ru/jour/article/view/821late onset neurosyphilissyphilismeningovascular syphilisserodiagnosis
spellingShingle T. L. Vizilo
T. V. Poponnikova
I. F. Fedoseeva
E. D. Vasenina
The difficulties of diagnosis of neurosyphilis at the modern stage
Лечащий Врач
late onset neurosyphilis
syphilis
meningovascular syphilis
serodiagnosis
title The difficulties of diagnosis of neurosyphilis at the modern stage
title_full The difficulties of diagnosis of neurosyphilis at the modern stage
title_fullStr The difficulties of diagnosis of neurosyphilis at the modern stage
title_full_unstemmed The difficulties of diagnosis of neurosyphilis at the modern stage
title_short The difficulties of diagnosis of neurosyphilis at the modern stage
title_sort difficulties of diagnosis of neurosyphilis at the modern stage
topic late onset neurosyphilis
syphilis
meningovascular syphilis
serodiagnosis
url https://journal.lvrach.ru/jour/article/view/821
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AT tvpoponnikova thedifficultiesofdiagnosisofneurosyphilisatthemodernstage
AT iffedoseeva thedifficultiesofdiagnosisofneurosyphilisatthemodernstage
AT edvasenina thedifficultiesofdiagnosisofneurosyphilisatthemodernstage
AT tlvizilo difficultiesofdiagnosisofneurosyphilisatthemodernstage
AT tvpoponnikova difficultiesofdiagnosisofneurosyphilisatthemodernstage
AT iffedoseeva difficultiesofdiagnosisofneurosyphilisatthemodernstage
AT edvasenina difficultiesofdiagnosisofneurosyphilisatthemodernstage