Current perspectives on neurosyphilis: pathogenic, diagnostic and therapeutic bases
DOI:
https://doi.org/10.36557/2674-8169.2024v6n5p428-439Keywords:
neurosyphilis; pathogenesis; diagnosis; treatmentAbstract
Introduction: Neurosyphilis (NS) is a serious and late manifestation of infection by Treponema pallidum, a bacterium that causes syphilis, which affects the central nervous system. This condition results from hematogenous spread of the pathogen to the nervous system, causing a variety of neurological symptoms. Objective: To evaluate the pathogenesis, diagnosis and management of neurosyphilis. Methodology: This is a bibliographic review that included original articles and systematic reviews in English and Portuguese, which addressed the pathogenic, diagnostic and therapeutic aspects of neurosyphilis, published between 2014 and 2024, selected from the PubMed, Scopus and SciELO databases. After careful selection, 28 articles were chosen to compose this bibliographic review. Results: T. pallidum presents a condition of complex immune evasion. The pathogenesis of NS involves complex biochemical interactions, including regulation of the antigenic variation system, imbalances between metalloproteinases. Diagnosis includes VDRL and TPPA tests, however, there are challenges associated with the tests. The management of the condition presents benzathine penicillin G as the first choice, in addition, other antibiotics can be used, such as doxycycline and ceftriaxone. Considerations: NS has a broad and complex pathogenesis, and includes multiple associated immune evasion mechanisms. Due to the difficulty of directly identifying the pathogen, diagnosis is associated with the identification of antibodies. Management includes antibiotic therapy, requiring careful clinical surveillance and individualized strategies to avoid possible adverse reactions and ensure the best possible management of this complex and multifaceted condition.
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Copyright (c) 2024 Mauro Alexandre Caixeta, Paulo Vytor Cardoso Nobre, Marcelo Cantarelli Correia da Silva Filho, Karina Araújo de Melo Tenorio de Souza, Maria Alice Lima de Santana , Ana Paula Barbosa Casado, Maria Luisa Vieira Cuyabano Leite, Guilherme Leite Cerqueira, Ana Carolina Maia Araújo, Lucas Rodrigues Pacífico Chagas, José Flávio Anacleto Segundo , José de Souza Vieira Neto , Kaique Lisboa Araújo
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