Clinical Spectrum Of 53 Neurosyphilis Patients

Objective: To analyze the clinical characteristics of 53 neurosyphilis patients from2000 to 2016 in the Qingdao University Hospital and The First Affiliated Hospital of Zhongshan University,provide a reference for clinicians.Methods: Patients were clinically diagnosed with neurosyphilis based on the interpretation of clinical and laboratory findings as recommended by the guidelines of the Centers for Disease Control(CDC)in the US.We retrospective analysis the clinical data of53 cases of neurosyphilis patients from 2000 to 2016 in the Qingdao University Hospital and The First Affiliated Hospital of Zhongshan University,including sex,age,marital history,also the laboratory examination and imaging examination,clinical symptoms and signs.Result:(1)A total of 53 patients met the inclusion criteria,including a total of 46 men and 7 women,all of them were Chinese except one.The age ranged from 20-80years(mean48.51years).(2)The most common clinical type was meningovascular syphilis(35.85%),followed by general paresis(28.30%),meningeal(11.32%),tabes dorsalis(7.55%),syphilitic meningomyelitis(9.43%),asymptomatic neurosyphilis(7.55%).The most common symptom was weakness of limbs(34%).(3)All neurosyphilis patients were serum Treponema pallidum particleagglutination(TPPA)and serum human immunodeficiency virus(HIV)antibody test,all patients were serum TPPA positive and HIV negative.47 cases followed the cerebrospinal fluid(CSF)routine examination,20 cases had CSF white blood cell increased,33 cases had CSF protein increased,while 19 cases had CSF white blood cell increased and CSF protein increased meanwhile,5 cases of CSF protein and white blood cells were normal.40 cases of neurosyphilis patients toked the brain magnetic resonance imaging(MRI),7 of them showed no abnormalities brain MRI performance,33 cases(17cases of meningovascular syphilis,1 case of meningeal neurosyphilis,11 cases of general paresis,1 case of tabes dorsalis,3 cases of syphilitic meningomyelitis)showed abnormalities brain MRI,including stroke-like performance,brain atrophy and white matter showed abnormal signal.Conclusion :1.In 53 cases of neurosyphilis patients,the most common clinical type of neurosyphilis is meningovascular neurosyphilis,so the clinical pattern had changed significantly.2.Serological examination,cerebrospinal fluid examination and imaging examination of3.neurosyphilis are not specific.Clinical diagnosising neurosyphilis need comprehensive epidemiology,clinical manifestation,laboratory examination and imaging examination.4.Syphilis serology should be performed in all patients with neuropsychiatric symptoms but no definite cause.When syphilis serology examination positive,the patient should carry on the cerebrospinal fluid examination,in order to avoid misdiagnosis.