Neuroborreliosis and Neurosyphilis

This article presents an overview of the current diagnosis and management of two spirochetal infections of the nervous system, neuroborreliosis (Lyme disease) and neurosyphilis, focusing on similarities and differences. Although neuroborreliosis was first identified almost a century ago, much confusion remains about how to accurately diagnose this quite treatable nervous system infection. Well-established diagnostic tools and therapeutic regimens exist for neurosyphilis, which has been well-known for centuries. RECENT FINDINGS Serologic testing targeting the C6 antigen may simplify diagnostic testing in neuroborreliosis while improving accuracy. Historically, screening for syphilis has used a reaginic test followed by a treponeme-specific assay; alternative approaches, including use of well-defined recombinant antigens, may improve sensitivity without sacrificing specificity. In neuroborreliosis, measurement of the chemokine CXCL13 in CSF may provide a useful marker of disease activity in the central nervous system. SUMMARY Lyme disease causes meningitis, cranial neuritis, radiculitis, and mononeuropathy multiplex. Cognitive symptoms, occurring either during (encephalopathy) or after infection (posttreatment Lyme disease syndrome) are rarely, if ever, due to central nervous system infection. Posttreatment Lyme disease syndrome is not antibiotic responsive. Syphilis causes meningitis, cranial neuritis, chronic meningovascular syphilis, tabes dorsalis, and parenchymal neu...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: Review Articles Source Type: research

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Conclusions:This case series illustrates important features currently attributed to neurosyphilis, which remains an important disease in Neurology, especially in some epidemiological risk groups.Disclosure: Dr. Borges has nothing to disclose. Dr. Germiniani has nothing to disclose. Dr. Koslyk has nothing to disclose. Dr. Teive has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
Conclusions:Although mechanical causes are high in the differential diagnosis of cervical radiculopathy, Lyme disease is well-known to have symptoms of radiculitis and should be considered in the assessment of cervical pain. A typical early syndrome due to neuroborreliosis has been characterized as a triad of the symptoms mentioned above including radicular pain, cranial or peripheral paresis, and lymphocytic meningitis and is called "Bannwarths syndrome" (Bannwarth, 1941).Disclosure: Dr. Hannoun has nothing to disclose. Dr. Gudin has received personal compensation for activities with Purdue, Endo, Astra Zeneca, ...
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
Conclusions:TB meningitis is a severe and frequently fatal cause of meningitis and vasculopathy. While well characterized and often on the initial differential for chronic meningitis, it is rarely encountered as a cause of acute meningitis in an immunocompetent population in the US. In this particular case rapid progression and likely secondary vasculopathy with brainstem infarcts precluded timely diagnosis and directed treatment.Disclosure: Dr. Utigard has nothing to disclose. Dr. Katyshev has nothing to disclose. Dr. Isada has nothing to disclose. Dr. Dani has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
Conclusions:Antibiotic treatment for S. pneumoniae meningitis correlated with improvement in clinical status and TCD hemodynamics. Serial TCDs may be a potentially useful strategy in the management of bacterial meningitis.Disclosure: Dr. Idris has nothing to disclose. Dr. Tai has nothing to disclose. Dr. Tan has nothing to disclose. Dr. Tan has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
Conclusions:Neuroinfections can masquerade as dementia and strong suspicion should be there while evaluating dementia especially in endemic regions. In our study SSPE, PML and Neurosyphilis were the most common infectious causes of dementiaDisclosure: Dr. Patil has nothing to disclose. Dr. Vishnu has nothing to disclose. Dr. Naheed has nothing to disclose. Dr. Goyal has nothing to disclose. Dr. Modi has nothing to disclose. Dr. Lal has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
Abstract Within 24 hours after antibiotic treatment of the spirochetal infections syphilis, Lyme disease, leptospirosis, and relapsing fever (RF), patients experience shaking chills, a rise in temperature, and intensification of skin rashes known as the Jarisch-Herxheimer reaction (JHR) with symptoms resolving a few hours later. Case reports indicate that the JHR can also include uterine contractions in pregnancy, worsening liver and renal function, acute respiratory distress syndrome, myocardial injury, hypotension, meningitis, alterations in consciousness, seizures, and strokes. Experimental evidence indicates i...
Source: The American Journal of Tropical Medicine and Hygiene - Category: Tropical Medicine Authors: Tags: Am J Trop Med Hyg Source Type: research
A 60-year-old man presented with an ataxic and spastic gait with paraparesis, having reported a tick bite. Brain MRI depicted bilateral corticospinal tract hyperintensities (figure). He had a mild lymphocytic meningitis (12 leukocytes/mm3, proteinorachia 1.48 g/L). ELISA was positive for Lyme disease in serum (immunoglobulin G [IgG] 176 UI and immunoglobulin M
Source: Neurology - Category: Neurology Authors: Tags: MRI, Bacterial infections NEUROIMAGES Source Type: research
Abstract On April 20, 2015, a female aged 15 years sought care at her pediatrician's office after 5 days of fever, myalgia, left parietal headache, and photophobia. A rapid influenza assay was negative, and erythrocyte sedimentation rate and total white blood cell count were normal. She improved with symptomatic care at home, but returned to her pediatrician's office on April 28, reporting recurrence of her headache and photophobia and new onset of a stiff neck. She was admitted to the hospital, where she was febrile to 102.9°F (39.4°C) and had meningismus. Computed tomography scan of her head was normal, ...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
Abstract Lyme borreliosis, infection with the tick-borne spirochete Borrelia burgdorferi sensu lato, causes nervous system involvement in 10–15 % of identified infected individuals. Not unlike the other well-known spirochetosis, syphilis, infection can be protracted, but is microbiologically curable in virtually all patients, regardless of disease duration. Diagnosis relies on 2-tier serologic testing, which after the first 4–6 weeks of infection is both highly sensitive and specific. After this early, acute phase, serologic testing should rely only on IgG reactivity. Nervous system involvement mo...
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
Spring is my favorite season. Warmer weather, budding flowers and lots of greenery in yards, gardens and parks encourages outside activities and fills me with energy. The spring season also brings out lots of crawling and flying critters like bees, butterflies, and hummingbirds, as well as some of the more unpleasant pests like ticks and mosquitos. If you enjoy spending time outside like I do, hiking, gardening or walking the dog, be aware that ticks and their bites can be not only annoying, but dangerous. Jana’s Experience Jana Braden found out how dangerous tick bites can be the hard way. She enjoyed the outdoors a...
Source: Disruptive Women in Health Care - Category: Consumer Health News Authors: Tags: Chronic Conditions Source Type: blogs
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