Prevalence of syphilis reactivity in patients with stroke, cognitive impairment and extrapyramidal syndromes: a retrospective study.

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Published Feb 25, 2021
DOI: https://doi.org/10.18103/mra.v9i2.2330

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Giulia Ciccarese, MD, PhD
Dermatology Clinic, Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10 16132, Genoa, Italy
Francesco Drago, MD
Dermatology Clinic, Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10 16132, Genoa, Italy; DI.S.Sal., Section of Dermatology, University of Genoa, Via Pastore, 1, 16132, Genoa, Italy
Bianco Drago, MD
Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
Aurora Parodi, MD
Dermatology Clinic, Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10 16132, Genoa, Italy; DI.S.Sal., Section of Dermatology, University of Genoa, Via Pastore, 1, 16132, Genoa, Italy

Abstract

In the last two decades, there has been a resurgence of syphilis worldwide. However, epidemiological data on neurosyphilis are inconsistent for the lack of reporting data and diagnostic gold standard tests. The aim of the present study was to estimate the prevalence of syphilis reactivity in a cohort of patients with neurological diseases of our hospital. We retrospectively analyzed the medical records of the patients hospitalized at the Stroke Unit of the Neurology Clinic and those suffering from cognitive impairment hospitalized at the acute ward of the Geriatrics Clinic between January 2017 and December 2019. Also the patients who attended the Movement disorder outpatient clinic during the same study period were examined. To detect syphilis reactivity a qualitative specific treponemal test on patient’s serum was performed: the Treponema pallidum haemagglutination assay (TPHA). A total of 652 patients were admitted and 315 of them (52%) were submitted to a routine screening for syphilis: 307 (97%) were negative while 8 (3%) had a positive syphilis serology. The TPHA-positive patients (4 males, 4 females) were 2 patients with stroke, 5 with cognitive impairment and 1 with Parkinsonism with a mean age of 83 years, suffering from multiple comorbidities. Although the patients we have retrospectively studied have not undergone lumbar puncture to confirm the diagnosis of neurosyphilis, the not negligible syphilis reactivity rate found in our series suggests that serological screening for syphilis should be reviewed as a routine screening test in neurology and geriatrics departments, especially if the clinical presentation of the neurological diseases is atypical.

Keywords: neurosyphilis, syphilis reactivity, stroke, cognitive impairment, Parkinsonism

Article Details

How to Cite
CICCARESE, Giulia et al. Prevalence of syphilis reactivity in patients with stroke, cognitive impairment and extrapyramidal syndromes: a retrospective study.. Medical Research Archives, [S.l.], v. 9, n. 2, feb. 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2330>. Date accessed: 24 nov. 2024. doi: https://doi.org/10.18103/mra.v9i2.2330.
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Vol 9 No 2 (2021): Volume 9 Issue 2, February, 2021
Section
Research Articles

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References

1. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015;64(RR-03):34–43.
2. Merritt HH, Adams RD, Solomon HC. Neurosyphilis. New York: Oxford University Press. 1946; 443.
3. Tuddenham S, Ghanem KG. Neurosyphilis: Knowledge Gaps and Controversies. Sex Transm Dis. 2018;45(3):147-151.
4. Gonzalez H, Koralnik IJ, Marra CM. Neurosyphilis. Semin Neurol. 2019; 39(4):448-455.
5. Skalnaya A, Fominykh V, Ivashchenko R, et al. Neurosyphilis in the modern era: Literature review and case series. J Clin Neurosci. 2019;69:67-73.
6. Drago F, Agnoletti AF, Ciccarese G, Cozzani E, Parodi A. Two cases of oligosymptomatic neurosyphilis in immunocompetent patients: Atypical neurosyphilis presentation. Int J STD AIDS. 2016;27(2):155-6.
7. Cozzani E, Gasparini G, Ciccarese G, et al. Concurrent benign tertiary syphilis and asymptomatic neurosyphilis in an immunocompetent patient. J Eur Acad Dermatol Venereol. 2020 Aug 18. doi: 10.1111/jdv.16882.
8. Drago F, Ciccarese G, Parodi A. Cerebrospinal fluid tests for neurosyphilis diagnosis. Sex Transm Infect. 2020;96(5):387.
9. Tan X, Zhang J, Li J, Yue X, Gong X. The prevalence of asymptomatic neurosyphilis among HIV-negative serofast patients in China: A meta-analysis. PLoS One. 2020;15(11):e0241572.
10. Drago F, Merlo G, Ciccarese G, et al. Changes in neurosyphilis presentation: a survey on 286 patients. J Eur Acad Dermatol Venereol. 2016;30(11):1886-1900.
11. Kingston M, French P, Higgins S et al. UK national guidelines on the management of syphilis 2015. Int J STD AIDS. 2016;27:421–446.
12. Janier M, Hegyi V, Dupin N et al. 2014 European guidelines on the management of syphilis. J Eur Acad Dermatol Venereol. 2015;29:1248.
13. Drago F, Ciccarese G, Cinotti E, Javor S, Rebora A, Parodi A. Screening, treatment, and follow-up of syphilis patients: Issues, concerns and efforts to improve current paradigms. Indian J Sex Transm Dis AIDS. 2015;36(1):112-114.
14. Drago F, Ciccarese G, Javor S, Parodi A. Syphilis screening, treatment and follow-up: strengths and weaknesses of the international guidelines. J Eur Acad Dermatol Venereol. 2016; 30(10):e77-e78.
15. Ahbeddou N, El Alaoui Taoussi K, Ibrahimi A, et al. Stroke and syphilis: A retrospective study of 53 patients. Rev Neurol (Paris). 2018; 174(5):313-318.
16. Pintado Maury I, Alves M, Fonseca T. Neurosyphilis prevalence at a Portuguese stroke unit care. Aging Clin Exp Res. 2019;31(8):1155-1161.
17. Cordato DJ, Djekic S, Taneja SR, et al. Prevalence of positive syphilis serology and meningovascular neurosyphilis in patients admitted with stroke and TIA from a culturally diverse population (2005-09). J Clin Neurosci. 2013; 20(7):943-947.
18. Dharmasaroja PA, Dharmasaroja P. Serum and cerebrospinal fluid profiles for syphilis in Thai patients with acute ischaemic stroke. Int J STD AIDS. 2012; 23(5):340-345.
19. Bowring J, Mahto M, Mandal D, et al. Stroke in pregnancy associated with syphilis. J Obstet Gynaecol Res. 2008; 34(3):405-407.
20. Feng W, Caplan M, Matheus MG, et al. Meningovascular syphilis with fatal vertebrobasilar occlusion. Am J Med Sci. 2009; 338(2):169-171.
21. Stefani A, Riello M, Rossini F, et al. Neurosyphilis manifesting with rapidly progressive dementia: report of three cases. Neurol Sci. 2013;34(11):2027-2030.
22. Sanford AM. Mild Cognitive Impairment. Clin Geriatr Med. 2017; 33(3):325-337.
23. Gyanwali B, Shaik MA, Hilal S, et al. Prevalence and association of syphilis reactivity in an Asian memory clinic population. Int J STD AIDS. 2018;956462418787627.
24. Powell AL, Coyne AC, Jen L. A retrospective study of syphilis seropositivity in a cohort of demented patients. Alzheimer Dis Assoc Disord. 1993; 7(1):33-38.
25. Vercelli M, Quaglia A, Lillini R, et al. Estimates of cancer burden in Liguria. Tumori. 2013; 99(3):285-295.
26. Miklossy J. Alzheimer's disease - a neurospirochetosis. Analysis of the evidence following Koch's and Hill's criteria. J Neuroinflammation. 2011;8:90.
27. Alam MZ, Alam Q, Kamal MA, et al. Infectious Agents and Neurodegenerative Diseases: Exploring the Links. Curr Top Med Chem. 2017; 17(12):1390-1399.
28. Miklossy J. Biology and neuropathology of dementia in syphilis and Lyme disease. Handb Clin Neurol. 2008; 89:825-44.
29. Fülöp T, Itzhaki RF, Balin BJ, et al. Role of Microbes in the Development of Alzheimer's Disease: State of the Art - An International Symposium Presented at the 2017 IAGG Congress in San Francisco. Front Genet. 2018; 9:362.
30. McAuley J, Hughes G. Neurosyphilis presenting as parkinsonism. BMJ Case Rep. 2015;2015: bcr2015210277.
31. Spitz M, Maia FM, Gomes HR, et al. Parkinsonism secondary to neurosyphilis. Mov Disord. 2008; 23(13):1948-1949.
32. Yin L, Zou S, Huang Y. Neurosyphilis with psychotic symptoms and Parkinsonism in a young girl. Neuropsychiatr Dis Treat. 2015; 11:375-377.
33. Drago F, Ciccarese G, Broccolo F, et al. A new enhanced antibiotic treatment for early and late syphilis. J Glob Antimicrob Resist. 2016; 5:64-66.
34. Drago F, Ciccarese G, Merlo G, Sartoris G, Parodi A. Is the Standard Treatment for Early Syphilis Sufficient to Prevent Cardiovascular and Neurologic Syphilis? Am J Cardiol. 2016; 117(2):310-1.
35. Drago F, Ciccarese G, Rebora A. Treatment of late-stage syphilis. JAMA. 2015; 313(9):969.
36. Liew ZQ, Ly V, Olson-Chen C. An old disease on the rise: new approaches to syphilis in pregnancy. Curr Opin Obstet Gynecol. 2020 Dec 15; doi: 10.1097/GCO.0000000000000683.
37. Ciccarese G, Drago F, Oddenino G, Crosetto S, Rebora A, Parodi A. Sexually transmitted infections in male prison inmates. Prevalence, level of knowledge and risky behaviours. Infez Med. 2020; 28(3):384-391.
38. Hernández-Bel P, Magdaleno-Tapial J. Syphilis Epidemic Still Uncontrolled in our Society: What Should Dermatologists Do? Actas Dermosifiliogr. 2019; 110(10):789-790.