Neurosyphilis Quiz

Study Notes

Update on Treatment, Prognosis, and Basic Research in Neurosyphilis

Treatment guidelines for neurosyphilis have been released by the United States, the United Kingdom, Europe, and China.
Penicillin is preferred worldwide as front-line therapy for neurosyphilis and is the only treatment modality certified for pregnant women with syphilis.
Ceftriaxone might be an alternative treatment to penicillin, but the efficacy of different therapies is still a major concern.
Steroids were recommended in some guidelines to prevent the Jarisch-Herxheimer reaction, which may occur within the first 24 hours of neurosyphilis treatment.
Serofast, a lack of serological response to antisyphilitic therapy, is currently a major concern for clinicians.
Several factors influence the prognosis of patients with neurosyphilis, such as diplopia, severe atrophy of brain parenchyma, and headache.
Reinfection of syphilis is more prevalent in MSM and PLWH, and molecular studies are necessary to determine whether the rise in RPR titer is due to reinfection or recurrence.
Recent basic research on neurosyphilis mainly focuses on the pathogenic mechanisms of neurosyphilis, and the potential biomarkers for diagnosis or prognosis monitoring.
T. pallidum crosses the endothelial barriers through interjunctional penetration, disseminating throughout the body and invading various organs.
T. pallidum can activate both humoral and cellular immunity, but cellular immunity is significantly suppressed in the late stage of infection.
Host immune response also plays an important role in the pathogenesis of neurosyphilis, mainly in the form of T cell-mediated delayed-type hypersensitivity.
Recent studies propose that CXCL13/CXCR5 mediated the accumulation of B cells and immunoglobulin G in the CSF of neurosyphilis patients; IL-17 not only mediated the inflammatory response but also activated endothelial contraction and destroyed the tight junctions of the BBB.Recent Advances in Neurosyphilis: Epidemiology, Clinical Manifestations, Laboratory Findings, Comorbidities, Diagnosis, Treatment, Prognosis, and Basic Research
The incidence of neurosyphilis has been increasing in recent years, mainly in MSM.
Neurosyphilis can mimic most neuro-ophthalmic, audio-vestibular, and psychiatric disorders.
Comorbidities of neurosyphilis are prevalent and variable, and patients may present with specific metabolic characteristics.
Clinical diagnostic methods remain immature.
Recent studies on long non-coding RNA, miRNA, chemokines, and metabolites in peripheral blood and CSF may facilitate the research on the pathogenesis and new indicators of neurosyphilis.
The resistance of T. pallidum to penicillin has not been discovered.
Ceftriaxone was found to be more effective than penicillin in some studies, but few large randomized controlled trials supported this view.
Lumbar puncture remains controversial in the diagnosis of neurosyphilis due to its difficulty of implementation and potential risks posed to patients.
The false-negative and false-positive rates remain high in a single treponemal or nontreponemal test, thus combined use of various diagnostic methods is recommended.
The cause of serofast is still unclear, and retreatment to serofast patients cannot significantly improve the cure rates.
Public education, partner notification, and screening projects are time-consuming and difficult to undertake.
Further research could concentrate on the pathogenesis, standards and guidelines, treatment modalities, JHR and serofast, follow-up, and the prevention of large-scale coinfection in MSM and PLWH.

Description

Test your knowledge on the latest updates in the field of neurosyphilis with this informative quiz. From treatment guidelines to basic research on the pathogenic mechanisms of neurosyphilis, this quiz covers a wide range of topics. Learn about the comorbidities, diagnosis, treatment, prognosis, and more. Enhance your understanding of this often misunderstood disease and stay up-to-date with the latest developments.