Table 5 Clinical Descriptions of Four seropositive for T.pallidum patients who had neurologic abnormalities and underwent lumbar puncture
Patient number | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
Gender | Male | Female | Female | Female |
Age in (years) | 50 | 65 | 57 | 30 |
ART use | Not on ART | yes | yes | yes |
Duration of ART | – | 4 months | 2 years | 7 year |
Neurologic features | Headache Confusion fever | -Disturbed memory | Confusion Hearing loss left Disturbed memory and cognition | Hearing loss right ear which is sensorineural No ear discharge Normal other system |
CD4+/uL | 412 | – | 219 | 270 |
Viral load (copies/Ul) | Not tested | Not tested | 19 | 19 |
CSF finding | -Positive VDRL -WBC < 5/uL Glucose low(2.99 mmol) -Normal protein -Cryptococcal antigen negative(CRAG) -Clear fluid with negative gram stain and culture -Opening pressure extremely high | Negative VDRL -WBC < 5/Ul -Normal glucose -Normal protein -Negative CRAG -Negative culture | Negative VDRL WBC < 5 cell/Ul Normal glucose Normal protein Negative culture Negative CRAG | -Negative VDRL WBC < 5cell/uL Normal glucose Normal protein Negative culture |
Diagnosis | Neurosyphilis with meningoencephalitis | Presumed HIV Encephalopathy | Presumed HIV Encephalopathy | Hypoacusis due to other causes |
Outcome. | Admitted to the ward and started on Ceftriaxone 2 g IV BD. Died after three days in the course of treatment in the ward. | Alive, cognition deficit improving on ART. | Discharged home alive but later died at home. | Alive and hearing deficit has improved |