Predictors of unfavorable outcome in neurosyphilis: Multicenter ID-IRI Study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10-27

AUTHORS

Derya Ozturk-Engin, Hakan Erdem, Rodrigo Hasbun, Shu-Hua Wang, Hulya Tireli, Pierre Tattevin, Xavier Argemi, Enora Ouamara-Digue, Andrea Gombos, Botond Lakatos, Fatma Sırmatel, Yasemin Cag, Abdullah Umut Pekok, Seniha Senbayrak, Ilker Inanç Balkan, Marie Gheno, Nuray Uzun, Selçuk Kaya, Gönül Cicek-Senturk, Gönül Şengöz, Recep Tekin, Mustafa Kemal Çelen, Saygın Nayman-Alpat, Pınar Ergen, Alper Şener, Canan Agalar, Sükran Köse, Ahmet Çagkan Inkaya, Figen Kaptan, Fahad Al-majid, Umit Savasci, Haluk Vahaboglu

ABSTRACT

Neurosyphilis (NS) has different clinical manifestations and can appear during any stage of syphilis. We aimed to identify the factors affecting poor outcome in NS patients. Patients with positive cerebrospinal fluid Venereal Disease Research Laboratory test, and positive serological serum treponemal or nontreponemal tests were classified as definite NS. The data of 141 patients with definite NS were submitted from 22 referral centers. Asymptomatic NS, syphilitic meningitis, meningovascular syphilis, tabes dorsalis, general paresis, and taboparesis were detected in 22 (15.6%), 67 (47.5%), 13 (9.2%), 10 (7%), 13 (9.2%), and 16 patients (11.3%), respectively. The number of HIV-positive patients was 43 (30.4%). The most common symptoms were headache (n = 55, 39%), fatigue (n = 52, 36.8%), and altered consciousness (50, 35.4%). Tabetic symptoms were detected in 28 (19.8%), paretic symptoms in 32 (22.6%), and vascular symptoms in 39 patients (27.6%). Eye involvement was detected in 19 of 80 patients (23.7%) who underwent eye examination and ear involvement was detected in eight of 25 patients (32%) who underwent ear examination. Crystallized penicillin was used in 109 (77.3%), procaine penicillin in seven (4.9%), ceftriaxone in 31 (21.9%), and doxycycline in five patients (3.5%). According to multivariate regression analysis, while headache was a protective factor in NS patients, double vision was significantly associated to poor outcome. We concluded that double vision indicated unfavorable outcome among NS patients. A high clinical suspicion is needed for the diagnosis NS. As determined in our study, the presence of headache in syphilitic patients can help in early diagnosis of central nervous system disease. More... »

PAGES

125-134

Author Affiliations

  • Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
  • Principal Coordinator of ID-IRI, Ankara, Turkey
  • Department of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA
  • Division of Infectious Diseases, Deparment of Internal Medicine, The Ohio State University, Columbus, OH, USA
  • Department of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
  • Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
  • Department of Infectious Diseases and Clinical Microbiology, Nouvel Hôpital Civil, Strasbourg, France
  • Department of Infectious Disease and Clinical Microbiology, Saint Laszlo Hospital Budapest, Budapest, Hungary
  • Department of Infectious Disease and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Private Erzurum Sifa Hospital, Erzurum, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
  • Department of Infectious Disease and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
  • Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Education Hospital, İzmir, Turkey
  • Department of Infectious Disease and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
  • Department of Infectious Diseases and Clinical Microbiology, Atatürk Training and Research Hospital, İzmir Kâtip Çelebi University, İzmir, Turkey
  • Department of Medicine, Infectious Diseases Division, King Saud University Hospital, Riyadh, Saudi Arabia
  • Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10096-018-3403-7

    DOI

    http://dx.doi.org/10.1007/s10096-018-3403-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1107880561

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30368740


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