EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Possibility of involvement of the central nervous system in the syphilitic process recognized. In modern conditions syphilis of the nervous system characterized clinically mainly blurred and low-symptom forms, lack of pathognomonic symptoms. This greatly complicates timely diagnosis of neurosyphilis. The development of syphilitic lesions of the nervous system may contribute to the presence of chronic infections, intoxications (especially alcohol and drug), immunological disorders, brain injuries and inflammatory diseases of the central nervous system in history. In addition, the cause of neurosyphilis may be insufficient treatment of early syphilis. At the same time, not diagnosed and promptly treated neurosyphilis can not be responsible for the serological resistance and slowed down a negative serological tests.

The aim was to study the quantitative and qualitative changes in the cerebrospinal fluid of patients with long-lasting positive serological reactions after treatment of syphilis.

Materials and methods. The selection criteria for the study were: transferred syphilis, for specific treatment, maintained a positive serological tests for syphilis.

All patients were assessed neurological status. In order to exclude specific lesions of the nervous system of patients underwent lumbar puncture.

In the CSF were determined by cell count, protein, sugar, chlorides, globulin reaction Pandey, colloidal reaction Lange and serological reactions (CFT cardiolipin and treponemal antigen in dilutions of 1:5, 1:1, and with whole FTA - с, TPHA and ELISA detection of specific immunoglobulin M and G).

Results and discussion. Beginning in 2000, we conducted a comprehensive survey of 242 individuals with serological resistance and delayed negative serological tests. Compromised somatic anamnesis of these patients was found in half the cases, a third of patients had neurological premorbid. Of those surveyed in 58 (24%) patients were identified early neurosyphilis. Of these, 43 (74,1%) have a history of treatment for early latent syphilis, 12 (20,7%) - secondary syphilis, 2 (3,5%) - the primary seropositive and 1 (1.7%) had treatment independently.

The study found that among patients with neurosyphilis identified the main part is composed of patients with asymptomatic forms (42.8%), 28.6% accounted for by patients with meningeal form of neurosyphilis, and 14, 3% were persons with meningovascular forms.

Conclusions. These data indicate that most neurosyphilis occurs in persons initially diagnosed with early latent syphilis, while among all forms of neurosyphilis was dominated by asymptomatic forms. The clinical experience shows the usefulness of inspection of likvor in patients with latent forms of syphilis before the start of specific therapy, as well as the need for careful examination of persons with long-lasting positive serological reactions to identify neurosyphilis even in the absence of specific clinical symptoms of CNS.