Syphilitic aseptic meningitis

  • Definition
    • Syphilitic aseptic meningitis is a complication of untreated syphilis. It involves inflammation of the tissues covering the brain and spinal cord.

  • Alternative Names
    • Meningitis - syphilitic

  • Causes
    • Syphilis is a sexually transmitted disease caused by the spirochete bacteria Treponema pallidum. Syphilis has three main stages:

      • Primary syphilis
      • Secondary syphilis
      • Tertiary syphilis

      Syphilitic aseptic meningitis is a form of meningovascular neurosyphilis. This condition is a life-threatening complication of syphilis infection.

      Syphilitic aseptic meningitis is similar to meningitis caused by other conditions.

      Risks for syphilitic aseptic meningitis include a past infection with syphilis or other sexually transmitted illnesses such as gonorrhea. Syphilis infections are mainly spread through sex with an infected person. Sometimes they may be passed by nonsexual contact.

  • Symptoms
  • Exams and Tests
  • Treatment
    • The goals of treatment are to cure the infection and stop symptoms from getting worse. Treating the infection helps prevent new nerve damage and may reduce symptoms. Treatment does not reverse existing damage.

      You will receive:

      • Penicillin or other antibiotics (such as tetracycline or erythromycin) for a long time to make sure the infection goes away
      • Spinal tap to remove a sample of spinal fluid for testing to see if the antibiotic worked
      • Medicines for seizures

      Some people may need help eating, dressing, and caring for themselves. Confusion and other mental changes may either improve or continue long-term after antibiotic treatment.

  • Outlook (Prognosis)
    • Late-stage syphilis can cause nerve or heart damage, which can lead to disability and death.

      Persons with late syphilis infections are more likely to have other complications, such as seizures.

  • Possible Complications
      • Inability to care for self
      • Inability to communicate or interact
      • Injury caused during seizures
      • Stroke
  • When to Contact a Medical Professional
    • Go to the emergency room or call the local emergency number (such as 911) if you have seizures.

      Call your health care provider if you have a severe headache with fever or other symptoms, especially if you have a history of syphilis infection.

  • Prevention
    • Proper treatment and follow-up of primary syphilis infections will reduce your risk of developing this type of meningitis.

      If you are sexually active, practice safe sex and always use condoms.

      All pregnant women should be screened for syphilis.

  • References
    • Hook EW III. Syphilis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 327.

      Thigpen MC, Whitney CG, Messonnier NE, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011;364:2016-2025.

      Tremont EC. Treponema pallidum (Syphilis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 238.

      Workowski KA, Berman S. Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010;59:1-110.