[Syphilis]. / Syphilis.

Syphilis is back since 2000. Early syphilis comprises primary syphilis, secondary syphilis and early latent syphilis (less than 1 year duration). During early phases of syphilis, patients are more contagious and neurologic complications are rare. Early neurosyphilis are mostly represented by uveitis or cranial nerves lesions. Treatment of non-neurologic syphilis are based on intramusculary injection of benzathine-penicilline G: one injection in case of early syphilis, three injections in case of late syphilis. The follow-up after treatment is based on clinical evolution and the titer of VDRL. Intravenously infusion of penicillin G is the only treatment recommended for neurosyphilis.

[Uveitis--a manifestation of syphilis]. / Uveitis--manifestation af syfilis.

We describe two cases of neurosyphilis whose diagnosis was based on ocular symptoms. Both patients were treated in the Eye Department for bilateral uveitis, and they were tested serologically positive for syphilis. The diagnoses of neurosyphilis were confirmed by demonstration of CSF pleocytosis and specific intrathecal antibody production. Both patients were treated with 21 million units of penicillin IV daily for 15 days. Ocular syphilis is an unusual manifestation of the disease but should be considered in patients with uveitis of uncertain origin, especially if the patient has a rash and/or headache.

Syphilis in the HIV-infected patient: an update on epidemiology, diagnosis, and management.

After a decade of unprecedented declines, incidence of early-stage syphilis in the United States and Europe has increased significantly since 2000. These cases have occurred at disproportionately elevated rates among people infected with HIV. Speculation continues as to whether the clinical spectrum of syphilis is qualitatively different among those individuals who are HIV infected. Recent data suggest that individuals who are immune compromised because of HIV have a higher likelihood of developing neurosyphilis. Recommendations for treatment of syphilis remain the same for patients with and without HIV.

Syphilis and HIV infection.

Treponema pallidum and HIV are both sexually transmitted agents of infectious diseases with epidemiological similarities. Ulcerous genital diseases such as primary syphilis facilitate transmission of HIV. An increasing number of case reports gives evidence that in HIV-infected patients secondary syphilis runs a more severe course and may present as syphilis maligna and that neurological complications of secondary and tertiary syphilis seem to occur more frequently and at an earlier stage. The clinical evaluation, interpretation of serology and choice of treatment schedules must take these considerations into account.