Clinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infection.

Clinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infection. Br J Ophthalmol. 2020 Mar 27;: Authors: Mathew D, Smit D Abstract BACKGROUND/AIMS: In the era of increasing incidence of syphilis globally, ocular syphilis is re-emerging as an important cause of uveitis. The aim of this study was to determine the clinical and laboratory characteristics of ocular- and neurosyphilis among individuals with and without HIV infection. METHODS: Retrospective analysis of patients diagnosed with ocular syphilis presenting to Tygerberg Hospital, South Africa, over a 5-year period ending December 2018. RESULTS: Two-hundred and fifteen eyes of 146 patients were included. HIV coinfection was present in 52.1% of the patients, with 23.7% of these patients being newly diagnosed on presentation. The median age was 36.5±9.8 years. Bilateral involvement occurred in 47.3%, with 68.1% of these patients being HIV positive. The most frequent form of intraocular inflammation was posterior uveitis (40.9%), followed by panuveitis (38.1%), both of which were more predominant in HIV-positive eyes. Seventy-four per cent of all eyes had a visual acuity ≤20/50 and 40%
Source: The British Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Br J Ophthalmol Source Type: research

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En mann i 40-årene med akutt innsettende talevansker og ensidig lammelse. Tidsskr Nor Laegeforen. 2019 Dec 10;139(18): Authors: Jahr SH, Myro AZ, Vegge K, Campbell P Abstract BACKGROUND: Stroke has several causes and the diagnostic investigation can be challenging. Neurosyphilis occurs when Treponema pallidum infects the central nervous system, and is a rare cause of stroke. CASE PRESENTATION: A man in in his late forties with diabetes mellitus and overweight presented with headache, speech impairment and right-sided stroke symptoms. He also had cognitive impairment and psychiatric symptoms...
Source: Tidsskrift for den Norske Laegeforening - Category: General Medicine Authors: Tags: Tidsskr Nor Laegeforen Source Type: research
This article reviews the clinical presentation, diagnosis, and treatment of neurosyphilis, and it addresses the controversy regarding the role of lumbar puncture early in the course of infection. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
We report the case of a 30-year-old man with ankylosing spondylitis who had begun receiving golimumab two weeks earlier. He presented with a 10-day history of salmon-colored lesions on trunk, palms and soles. The clinical suspicion was secondary syphilis. Treponemal and nontreponemal tests confirmed the diagnosis of syphilis. Lumbar puncture was also performed, although there was no neurological involvement, to rule out neurosyphilis. Cases of syphilis in patients in treatment with TNF-alpha inhibitors are uncommon in the literature and there are no established protocols.ResumenLos fármacos inhibidores del factor de...
Source: Reumatologia Clinica - Category: Rheumatology Source Type: research
ConclusionsThis large number of potentially unnecessary LPs, along with heterogeneity of presentation, and the never ‐nil risk of asymptomatic neurosyphilis should be incorporated into clinical decision‐making. The majority of PLWH presenting with a serological diagnosis of syphilis, but no neurological signs or symptoms, do not necessarily require an LP for an evaluation of asymptomatic neurosyphilis.
Source: HIV Medicine - Category: Infectious Diseases Authors: Tags: Original Research Source Type: research
CONCLUSION: We observed a low prevalence of NS (0.31%), but this result was surprisingly higher than what was expected in an elderly population. PMID: 30343380 [PubMed - as supplied by publisher]
Source: Aging Clinical and Experimental Research - Category: Geriatrics Authors: Tags: Aging Clin Exp Res Source Type: research
CONCLUSION: The majority of patients (64.8%) who underwent lumbar puncture had cerebrospinal fluid findings suggestive of neurosyphilis. Elevated CSF lymphocyte cell count and total protein count are highly suggestive of neurosyphilis. PMID: 30230943 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
We present the case of an 80-year-old woman, single with no children, who lived alone, and, up until presentation, was able to perform activities of daily living self-sufficiently. She reported to have the support of friends and neighbors, and she lived in the small community of São Miguel Island, Azores, Portugal. She had completed two years of college before dropping out during her third year, and her last job was as an elder care-worker. She had no personal or family psychiatric antecedents and no history of alcohol or illicit drug addictions. The patient was diagnosed with DM2 two years previously and was treate...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue acute confusional state delirium diabetes hyperglycemia psychosis Source Type: research
Abstract Syphilis is a resurgent sexually transmitted infection in the UK that is disproportionately diagnosed in patients living with HIV, particularly in men who have sex with men. Syphilis appears to present differently in patients with HIV, particularly in those with severe immunosuppression. Progression to neurosyphilis is more common in HIV coinfection and can be asymptomatic, often for several years. The presentations of neurosyphilis vary but can include meningitis, meningovascular disease, general paresis and tabes dorsalis. There is debate about the circumstances in which to perform a lumbar puncture, an...
Source: Practical Neurology - Category: Neurology Authors: Tags: Pract Neurol Source Type: research
ObjectivesDespite adequate suppression of plasma HIV RNA, viral escape in cerebrospinal fluid (CSF) is widely reported. Rates of CSF HIV RNA escape vary in the literature. In persons living with HIV (PLWH) undergoing lumbar puncture examination for clinical reasons, we assessed rates of CSF HIV RNA escape. MethodsPersons living with HIV attending a designated HIV neurology service undergoing CSF assessment for clinical reasons between January 2015 and April 2017 were included in the study. CSF HIV RNA escape was defined as HIV RNA ≥ 0.5 log10 HIV‐1 RNA copies/mL higher than plasma HIV RNA or detectable CSF HIV RN...
Source: HIV Medicine - Category: Infectious Diseases Authors: Tags: Short Communication Source Type: research
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