Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lanska, M. J.
Right arrow Articles by Schmidley, J. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lanska, M. J.
Right arrow Articles by Schmidley, J. W.
NEUROLOGY 1988;38:1297
© 1988 American Academy of Neurology

Syphilitic polyradiculopathy in an HIV-positive man

Mary Jo Lanska, MD, Douglas J. Lanska, MD and James W. Schmidley, MD

Department of Neurology, University Hospitals of Cleveland, and Case Western Reserve University School of Medicine, Cleveland, OH.

We report a case of syphilitic lumbosacral polyradiculopathy in an HIV-positive, 22-year-old bisexual man with a recent history of secondary syphilis treated with intramuscular penicillin. He presented with rapidly progressive pain and weakness, and muscle wasting in the legs. CSF was under increased pressure and showed a marked pleocytosis (1,130 cells/mm3), hypoglycorrhachia (19 mg/dl), and very elevated protein (1,000 mg/dl). Serum and CSF VDRL serologies were positive. In the legs, nerve conduction studies and needle EMG were consistent with an asymmetric lumbosacral polyradiculopathy with active denervation. His clinical state, CSF, and electrophysiologic studies all improved promptly and markedly after intravenous penicillin. This report documents an uncharacteristically aggressive case of neurosyphilis accompanied by marked changes in the CSF in an HIV-positive patient. While the immunologic effects of HIV and syphilis in combination are not yet fully understood, the cellular immunity defect associated with HIV may alter the natural history of syphilis in patients with concomitant infection, producing unusually aggressive forms or atypical presentations of neurosyphilis.

Address correspondence and reprint requests to Dr. Mary Jo Lanska, Department of Neurology, University Hospitals of Cleveland, 2074 Abington Road, Cleveland, OH 44106.

Presented in part at the fortieth annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.

Received October 20, 1987. Accepted for publication in final form December 7, 1987.




This article has been cited by other articles:


Home page
 Mayo Clin Proc.Home page
S. Ferrari, S. Vento, S. Monaco, T. Cavallaro, F. Cainelli, N. Rizzuto, and Z. Temesgen
Human Immunodeficiency Virus-Associated Peripheral Neuropathies
Mayo Clin. Proc., February 1, 2006; 81(2): 213 - 219.
[Abstract] [Full Text] [PDF]

Home page
 Sex. Transm. Infect.Home page
A Winston, D Marriott, and B Brew
Early syphilis presenting as a painful polyradiculopathy in an HIV positive individual
Sex Transm Inf, April 1, 2005; 81(2): 133 - 134.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
T. Etgen, C. Bischoff, M. Resch, K. Winbeck, B. Conrad, and D. Sander
Obstacles in the diagnosis and treatment of syphilitic amyotrophy
Neurology, February 11, 2003; 60(3): 509 - 511.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
R. T. Rolfs, M. R. Joesoef, E. F. Hendershot, A. M. Rompalo, M. H. Augenbraun, M. Chiu, G. Bolan, S. C. Johnson, P. French, E. Steen, et al.
A Randomized Trial of Enhanced Therapy for Early Syphilis in Patients with and without Human Immunodeficiency Virus Infection
N. Engl. J. Med., July 31, 1997; 337(5): 307 - 314.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
S. M. Gordon, M. E. Eaton, R. George, S. Larsen, S. A. Lukehart, J. Kuypers, C. M. Marra, and S. Thompson
The Response of Symptomatic Neurosyphilis to High-Dose Intravenous Penicillin G in Patients with Human Immunodeficiency Virus Infection
N. Engl. J. Med., December 1, 1994; 331(22): 1469 - 1473.
[Abstract] [Full Text]

Home page
 Arch NeurolHome page
D. A. Katz, J. R. Berger, and R. C. Duncan
Neurosyphilis: A Comparative Study of the Effects of Infection With Human Immunodeficiency Virus
Arch Neurol, March 1, 1993; 50(3): 243 - 249.
[Abstract] [PDF]

Home page
 Arch Intern MedHome page
M. J. DiNubile, J. D. Baxter, and T. R. Mirsen
Acute Syphilitic Meningitis in a Man With Seropositivity for Human Immunodeficiency Virus Infection and Normal Numbers of CD4 T Lymphocytes
Arch Intern Med, June 1, 1992; 152(6): 1326 - 1327.
[Abstract] [PDF]

Home page
 ANN INTERN MEDHome page
D. M. Musher, R. J. Hamill, and R. E. Baughn
Effect of Human Immunodeficiency Virus (HIV) Infection on the Course of Syphilis and on the Response to Treatment
Ann Intern Med, December 1, 1990; 113(11): 872 - 881.
[Abstract] [PDF]

Home page
 Arch NeurolHome page
D. J. Lanska and M. J. Lanska
Treatable Causes of Meningomyeloradiculitis in Individuals Infected With Human Immunodeficiency Virus
Arch Neurol, July 1, 1989; 46(7): 722 - 723.
[Abstract] [PDF]

Home page
 Arch NeurolHome page
R. M. Woolsey
Treatable Causes of Meningomyeloradiculitis in Individuals Infected With Human Immunodeficiency Virus-Reply
Arch Neurol, July 1, 1989; 46(7): 723 - 723.
[Abstract] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1988 by AAN Enterprises, Inc.