Analysis on clinical features and treatment of 38 patients with neurosyphilis / 中国医师进修杂志

ABSTRACT

Objective To explore the clinical features,diagnosis and treatment of neurosyphilis.Methods The clinical data of 38 patients with neurosyphilis were analyzed.Results Among the 38 patients,2 cases were asymptomatic neurosyphilis,3 cases were syphilitic meningitis,16 cases were meningovascular syphilis,13 cases were paralytic dementia,and 4 cases were spinal tuberculosis.All 38 patients were positive in rapid plasma reagin test (RPRT),treponema pallidum hemagglutination assay (TPHA) of blood and TPHA of cerebrospinal fluid,32 cases (86.84％,33/38) were positive in RPRT of cerebrospinal fluid,and 5 cases (13.16％,5/38) were negative in RPRT of cerebrospinal fluid.All patients were improved in clinical symptom after treatment.RPRT of blood and cerebrospinal fluid were decreased but still positive,and the leukocyte and protein concentrations of cerebrospinal fluid were normal in 13 cases (34.21％,13/38).Six months after treatment,RPRT of blood and eerebrospinal fluid were negative in 17 cases (44.74％,17/38).The leukocyte and protein concentrations of cerebrospinal fluid were normal in 33 cases (86.84％,33/38).Conclusions Clinical manifestation of neurosyphilis is variety,and easily misdiagnosed.Syphilis examination in blood and cerebrospinal fluid is the necessary basis for diagnosis.Penicillin is the drug of first choice for the treatment.Cerebrospinal fluid leukocyte and protein concentrations are sensitive indicators to monitor the effect.