The symptoms and treatment of syphilis of the nervous system
Treponema pallidum spreads through the nervous system mainly by lymphogenous. The microorganism is found in the subarachnoid space of the bone marrow in the first days after infection. Getting into the soft tissue of the brain, Treponema causes a persistent inflammatory process. Then the inflammation goes on all the components of the nervous system, causing their destruction.
Depending on the location of the source of infection and the stage of development of syphilis of the nervous system is divided into 2 forms - early and late. Neuro-syphilis in the early stage is characterized by point changes in the tissues of the cerebral cortex and blood vessels. Late neurosyphilis causes the destruction of sensitive neurons. Affects most often the roots of the bone marrow, but the process may affect gray matter and nerve endings of the spinal cord.
In the early stages of syphilis may not have symptoms, then there is a syphilitic meningitis and gum, bone and brain. In the later stages may develop paralysis and tabes bone marrow. Asymptomatic neurosyphilis can be identified by analyzing bone marrow fluid in the first years after infection. In the analysis of blood revealed elevated protein, lymphocytic pleocytosis, and a positive globulin reaction. This form of syphilis shows itself in almost all infected.
Syphilitic meningitis may be acute or chronic. This files most often occurs in the absence of adequate treatment in the first years after infection. The main symptom of infectious meningitis are headaches, intolerance of light and sound, nausea. Damage to the nervous system in syphilis occurs in the cortex of the brain, so it affects the optic and facial nerves. In bone marrow fluid is determined by elevated levels of lymphocytes and protein, Wassermann reaction positive. The composition of the bone-marrow tissue in syphilitic meningitis is similar to its composition in serous meningitis. In some cases, neurosyphilis is combined with secondary syphilis. A few years after infected, the disease becomes chronic.
5-30 years after the start may develop meningovascular form of syphilis that is characterized by inflammation of the cerebral cortex. Meningeal symptoms may be absent, globulin reaction and Wassermann reaction are positive. In addition to the meningesaffected vessels in the brain that can cause strokes. The main symptoms of syphilis are meningovascular headaches and impaired memory.
Gummas is a tumor of medium size, occurring in the tissues of the brain. It is a little different from other brain tumors. The increase in the gum provokes an increase in cranial pressure, paralysis of limbs, decreased vision and sensitivity.
Spinal tabes may develop 10-20 years after infection. The inflammatory process involves the spinal roots of the lumbar and pelvic divisions of the bone marrow. The spinal cord when viewed from the outside has the appearance of a fine structure with a muddy shell. The name "tabes" this form of syphilis was due to the fact that it causes drying of the bone marrow of the patient.
Diagnosis and treatment
Identify the disease is quite difficult. Only a small proportion of patients admitted that they were sick with syphilis. In addition, a growing number of asymptomatic cases of the disease. The diagnosis can be made based on the analysis of blood and bone marrow fluid. Syphilitic origin of the disease can be detected through serological reactions and analysis of cerebrospinal fluid for the Wassermann reaction. Some medical laboratories have used the method of polymerase chain reaction for detection of Treponema pallidum DNA in blood plasma. Especially carefully it is necessary to diagnose spinal suchocki.
Therapy includes intramuscular administration of large doses of the antibiotic penicillin.
There are 2 methods of penicillin therapy. In the first case, used the introduction of penicillin intravenously 4-5 times a day for 2 weeks. After completion of the course the treatment continues with the use of retarpena, which is administered 1 time per day for 21 days.
The second method involves intramuscular injections of procaine penicillin in the solution for 1-2 weeks with further application retarpena for 3 weeks. Additionally, we recommend the use of probenecid - a drug used in the treatment of gout. It regulates the excretion of the antibiotic by the kidneys, resulting in high concentration of these drugs in serum. If the patient is allergic to the antibiotic penicillin, used cyclosporine.
Antibiotics should be accompanied by restorative therapy, including ingestion of iodine-containing drugs. 3% solution of sodium iodide must take 50 ml per day for 3-4 weeks. In addition, appointed b vitamins, vitamin C, drugs that improve the microcirculation. In some cases there arephysiotherapeutic methods. The effectiveness of treatment is determined by analysis of cerebrospinal fluid and blood. Pleocytosis returns to normal in about 2 years after the end of treatment. The Wassermann reaction becomes negative only after 3 years after carrying out of antibacterial therapy.