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Neurosyphilis: a series of 178 cases at the 3rd-level hospital of Marrakesh (Morocco)

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Abstract

Neurosyphilis (NS) is an infection of the central nervous system (CNS), caused by Treponema pallidum. Up to 4–10% of patients with untreated syphilis may develop NS which still constitutes a health challenge. The aim of this study is to analyze epidemiological, clinical, paraclinical, therapeutic, and progression profiles of NS in the south of Morocco. Authors analyzed retrospectively 178 files of patients with neurosyphilis, collected in the Neurology Department of Marrakesh over 25 years from January 1994 to March 2019. In our study, the mean age was 46 years (17–75 years). The number of males was dominant (87.6%). The most common presentation was meningoencephalitis. Four cases were atypical (late congenital syphilis, amyotrophic lateral sclerosis, neurosyphilis associated with neuro-Behcet’s disease, and acute polyradiculoneuropathy). All patients had positive TPHA and VDRL serologies in blood; CSF-TPHA was positive in all patients, and CSF-VDRL was positive in 64.0% of patients. CT scan and brain MRI showed cortical atrophy in the majority of cases. One hundred seventy-seven patients were treated with intravenous injection of aqueous penicillin G. Neurosyphilis is still a significant medical problem in developing countries, and its occurrence in HIV infection is the reason for a growing number of new cases in developed countries. Given the frequent atypical manifestations of the disease, screening for neurosyphilis should be considered in all patients with neurological or psychiatric symptoms.

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Acknowledgements

The authors are indebted to the staff of the Department of Neurology at Marrakesh University Hospital for their kind cooperation in the collection of data.

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Authors and Affiliations

  1. Neuroscience Research Laboratory of Marrakech Medical School, Cadi Ayyad University, Marrakesh, Morocco

    Najib Kissani & Nisserine Louhab

  2. Neurology Department, University Hospital Mohamed VI, Marrakesh, Morocco

    Najib Kissani, Sanaa Nafia, Safaa Zahlane & Nisserine Louhab

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  1. Najib Kissani
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  2. Sanaa Nafia
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  4. Nisserine Louhab
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Kissani, N., Nafia, S., Zahlane, S. et al. Neurosyphilis: a series of 178 cases at the 3rd-level hospital of Marrakesh (Morocco). Eur J Clin Microbiol Infect Dis 40, 2129–2135 (2021). https://doi.org/10.1007/s10096-021-04253-y

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