Tertiary Syphilis in the Cervical Spine: a Case Report and Review of the Literature

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2014 Jan 18

PMID 24436850

Citations 6

Authors

K M I Salem

H Majeed

R Bommireddy

Z Klezl

Affiliations

Soon will be listed here.

Abstract

As the prevalence of syphilis rises, an increase in tertiary syphilis with spinal involvement is predicted. We report what we believe to be the first case of compressive cervical spine syphilitic gummata, with central cord compression signs. We also review the relevant literature to date. The diagnosis of syphilis in the spine relies on the physician to be aware of it as part of the differential diagnosis. Treponemal laboratory tests are an important aid in establishing a diagnosis.

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Tertiary syphilis in the lumbar spine: a case report.

Bai Y, Niu F, Liu L, Sha H, Wang Y, Zhao S BMC Infect Dis. 2017; 17(1):513.

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References

Stamm L . Global challenge of antibiotic-resistant Treponema pallidum. Antimicrob Agents Chemother. 2009; 54(2):583-9. PMC: 2812177. DOI: 10.1128/AAC.01095-09. View

Ramani P, Sengupta R . Cauda equina compression due to tabetic arthropathy of the spine. J Neurol Neurosurg Psychiatry. 1973; 36(2):260-4. PMC: 1083562. DOI: 10.1136/jnnp.36.2.260. View

Natale M, Muras I, Cioffi F, Bernini F . Syphilitic spinal arthropathy. Acta Neurochir (Wien). 2002; 143(12):1299-300. DOI: 10.1007/pl00010097. View

Allali F, Rahmouni R, Hajjaj-Hassouni N . Tabetic arthropathy. A report of 43 cases. Clin Rheumatol. 2006; 25(6):858-60. DOI: 10.1007/s10067-006-0205-6. View

Harrison L . The Oslo study of untreated syphilis, review and commentary. Br J Vener Dis. 1956; 32(2):70-8. PMC: 1054082. DOI: 10.1136/sti.32.2.70. View

Avenel G, Goeb V, Abboud P, Ait-Abdesselam T, Vittecoq O . Atypical forms of syphilis: two cases. Joint Bone Spine. 2009; 76(3):293-5. DOI: 10.1016/j.jbspin.2008.10.012. View

Gjestland T . The Oslo study of untreated syphilis; an epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material. Acta Derm Venereol Suppl (Stockh). 1955; 35(Suppl 34):3-368; Annex I-LVI. DOI: 10.2340/00015555343368. View

Hannuksela M, KARAHARJU E . Syphilis of the spine. Br J Vener Dis. 1972; 48(5):397-9. PMC: 1048350. DOI: 10.1136/sti.48.5.397. View

Ho E, Lukehart S . Syphilis: using modern approaches to understand an old disease. J Clin Invest. 2011; 121(12):4584-92. PMC: 3225993. DOI: 10.1172/JCI57173. View

10.

Kent M, Romanelli F . Reexamining syphilis: an update on epidemiology, clinical manifestations, and management. Ann Pharmacother. 2008; 42(2):226-36. DOI: 10.1345/aph.1K086. View

11.

Nielsen J . Follow-up of syphilitics; late manifestations in 467 male patients with early syphilis followed for 29-36 years. Acta Derm Venereol. 1950; 30(6):507-12. View

12.

Lukehart S, Hook 3rd E, Collier A, Critchlow C, Handsfield H . Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment. Ann Intern Med. 1988; 109(11):855-62. DOI: 10.7326/0003-4819-109-11-855. View

13.

Schober P, Gabriel G, White P, Felton W, Thin R . How infectious is syphilis?. Br J Vener Dis. 1983; 59(4):217-9. PMC: 1046186. DOI: 10.1136/sti.59.4.217. View

14.

THOMAS D . Vertebral osteoarthropathy of Charcot's disease of the spine. J Bone Joint Surg Br. 1952; 34-B(2):248-55. DOI: 10.1302/0301-620X.34B2.248. View

15.

Park Y, Taylor J, Szollar S, Resnick D . Imaging findings in spinal neuroarthropathy. Spine (Phila Pa 1976). 1994; 19(13):1499-504. DOI: 10.1097/00007632-199407000-00015. View

16.

McNeel D, EHNI G . Charcot joint of the lumbar spine. J Neurosurg. 1969; 30(1):55-61. DOI: 10.3171/jns.1969.30.1.0055. View

17.

Eccleston K, Collins L, Higgins S . Primary syphilis. Int J STD AIDS. 2008; 19(3):145-51. DOI: 10.1258/ijsa.2007.007258. View

18.

Kingston M, French P, Goh B, Goold P, Higgins S, Sukthankar A . UK National Guidelines on the Management of Syphilis 2008. Int J STD AIDS. 2008; 19(11):729-40. DOI: 10.1258/ijsa.2008.008279. View

19.

Righarts A, Simms I, Wallace L, Solomou M, Fenton K . Syphilis surveillance and epidemiology in the United Kingdom. Euro Surveill. 2005; 9(12):21-5. View

20.

Radhakrishnan K, Vijayan V, Ashok P, Sridharan R, Mousa M . Syphilitic spinal neuroarthropathy with paraplegia. Clin Neurol Neurosurg. 1985; 87(1):61-4. DOI: 10.1016/0303-8467(85)90071-x. View