Analysis Of The Clinical Features And Treatments Of 5 Cases Of Neurosyphilis

Objective:Report 5 cases of neurosyphilis.To explore the clinical manifestations,laboratory and imaging characteristics,as well as the treatment and prognosis of neurosyphilis,thus to improve the dermatologists'clinician awareness of the disease.Methods:Collecting the patients clinical medical records and reviewing the related literatures,to summarize the clinical features,laboratory examinations,imaging examinations,diagnosis,treatment points and prognosis of neurosyphilis.Results:1.Among the 5 patients,4 cases were male and 1 case was female.All 5patients were married,and two of them were couple.1 case had history of syphilis,3cases had a history of unclean contact,1 case had a history of drug addiction,and 1case of infection was found due to a spouse's diagnosis of syphilis.2.With dizziness and headache as the first symptom,there were two cases with inarticulate speech,slow response,memory loss,confusion and physical activity disorder.In addition,there were 2 cases of blurred vision and decreased vision,and 1 case with no symptoms.The course of illness is 1-3 months.3.Serum TPPA and RPR were positive in all patients.(4)The CSF TPPA or TPAb were positive in 5 patients,and 2 positive and 3 negative cases were detected in CSF RPR.4.3 cases with increased CSF protein content(>500 mg/L)and 3 cases with increased white blood cell count(?5×10~6/L).5.3 cases of patients were examined by Cranial MRI.1 case of patients was with no abnormalities,and 2 cases has multiple small focal ischemic brain,which including 1 case with the symptom of abnormal signal in bilateral frontal and temporal pole,brain atrophy and brain's white matter changes.6.The patients were diagnosis with neurosyphilis.7.All of the patients were provided with 2400×10~6U/d(1times/day)intravenous drip of penicillin sodium for 14 consecutive days,and then the intramuscular injection of benzathine as 2.40×10~6U(1times/week)was administered for 3 weeks.8.The symptoms began to improve gradually during the second to sixth day of intravenous infusion of penicillin sodium in 4 patients with symptoms.The clinical symptoms of 4 following up patients were significantly improved and even subsided.Both serology and cerebrospinal fluid examination were better than before,and 1 case showed a significantly reduced lesion from Cranial MRI Conclusion:The clinical manifestations of neurosyphilis are complicated and without any characteristics.The cerebrospinal fluid examination has important significance in the diagnosis and treatment of the disease.Cranial MRI can be used as an auxiliary means to evaluate the treatment and prognosis.