Neurosyphilis: Three Cases

Öz

"The great imitator" syphilis is a disease that involves multisystem involvement caused by Treponema pallidum. Neurosyphilis, which is the central nervous system involvement of syphilis, is generally seen in secondary and tertiary stages, but it can occur at any stage. With the increasing number of syphilis cases, the risk of neurosyphilis has also increased in cases that are untreated or inadequately treated 4-10 years after the primary infection. Therefore, it is a disease that should be considered in the differential diagnosis of neurological and psychiatric disorders. Neurological involvement can manifest as motor and sensory impairment, ophthalmic and auditory symptoms, cranial nerve paralysis, and signs of meningitis. Ocular findings related to the disease are important markers of central nervous system (CNS) involvement. The most common psychiatric disorders observed are dementia, depression, and grandiosity. In this context, three cases of neurosyphilis followed in our clinic in 2023, which are rarely encountered but have been increasing in number, are shared to draw attention to the subject.

Anahtar Kelimeler

• Neurosyphilis
• T. pallidum
• visual impairment

NÖROSİFİLİZ: ÜÇ OLGU

Öz

“Büyük taklitçi” sifiliz, Treponema pallidum’un neden olduğu multisistemik tutulum yapan bir hastalıktır. Nörosifiliz, yani sifilizin santral sinir sistemi (SSS) tutulumu genellikle sekonder ve tersiyer evrelerinde görülmekle birlikte her evrede karşımıza çıkabilir. Artan sifiliz olgu sayılarına paralel olarak primer enfeksiyondan 4-10 yıl sonra tedavi edilmeyen veya yetersiz tedavi gören olgularda nörosifiliz riski de artmıştır. Bu nedenle nörolojik ve psikiyatrik bozuklukların ayırıcı tanısında akılda tutulması gereken bir hastalıktır. Nörolojik tutulumda motor ve duyusal etkilenme, oftalmik ve işitsel semptomlar, kranial sinir paralizileri, menenjit semptom ve bulguları görülebilir. Hastalığa bağlı oküler bulgular SSS tutulumunun önemli belirteçlerindendir. En sık görülen psikiyatrik bozukluklar ise demans, depresyon ve grandiyozitedir. Burada kliniğimizde nadir olarak karşılaştığımız ancak artan sayılarla birlikte 2023 yılında takip edilen, farklı nörolojik ve oküler bulgular ile başvurmuş olan üç nörosifiliz olgusu konuya dikkat çekmek amacı ile paylaşılmıştır.

Anahtar Kelimeler

• görme bozukluğu
• nörosifliz
• T.pallidum

Kaynakça

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