Treatment Challenges in a Severe Case of Syphilitic Myelitis With a Longitudinally Extensive Spinal Cord Lesion. (Record no. 12599)
[ view plain ]
| 000 -LEADER | |
|---|---|
| fixed length control field | 03699nam a22004697a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 230626s20222022 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER | |
| International Standard Serial Number | 1941-8744 |
| 024 ## - OTHER STANDARD IDENTIFIER | |
| Standard number or code | 10.1177_19418744221075402 [pii] |
| 024 ## - OTHER STANDARD IDENTIFIER | |
| Standard number or code | 10.1177/19418744221075402 [doi] |
| 024 ## - OTHER STANDARD IDENTIFIER | |
| Standard number or code | PMC8995592 [pmc] |
| 040 ## - CATALOGING SOURCE | |
| Original cataloging agency | Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) | |
| PMID | 35419144 |
| 245 ## - TITLE STATEMENT | |
| Title | Treatment Challenges in a Severe Case of Syphilitic Myelitis With a Longitudinally Extensive Spinal Cord Lesion. |
| 251 ## - Source | |
| Source | The Neurohospitalist. 12(2):400-403, 2022 Apr. |
| 252 ## - Abbreviated Source | |
| Abbreviated source | Neurohospitalist. 12(2):400-403, 2022 Apr. |
| 253 ## - Journal Name | |
| Journal name | The Neurohospitalist |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Year | 2022 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Manufacturer | FY2022 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Publication date | 2022 Apr |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] | |
| Publication status | ppublish |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] | |
| Medline status | PubMed-not-MEDLINE |
| 266 ## - Date added to catalog | |
| Date added to catalog | 2023-06-26 |
| 520 ## - SUMMARY, ETC. | |
| Abstract | Syphilitic myelitis is an unusual manifestation of neurosyphilis, rarely reported in the literature. The best management approach remains unclear in severe cases with longitudinally extensive spinal cord lesions. We describe a 29-year-old man with a history of incompletely treated syphilis after a high-risk sexual encounter, who presented two years later with several weeks of progressive numbness and weakness in both legs. MRI spine showed significant cord expansion from the craniocervical junction to T6 with patchy cord enhancement. He was diagnosed with syphilitic myelitis given his history of inadequately treated syphilis, positive serum rapid plasma reagin at a high titer, and CSF pleocytosis with elevated protein along with a reactive CSF Venereal Disease Research Laboratory test. Alternative infectious or immunological etiologies were excluded. He was treated with IV penicillin and pulse steroid therapy with IV methylprednisolone 1 g daily for 3 days with improvement. However, he was soon readmitted with recurrent weakness requiring an additional course of pulse steroid therapy followed by a short prednisone taper. Afterward, his symptoms recurred with worsened cord expansion on imaging. He was re-treated with IV penicillin and pulse steroid therapy with a more prolonged prednisone taper. The patient subsequently improved and had no further recurrent symptoms on extended outpatient follow-up. This report illustrates the importance of keeping syphilitic myelitis on the differential as a treatable cause of longitudinally extensive myelopathy. The patient may have benefited from high-dose IV steroids with a prolonged taper while waiting for the full treatment effect of antibiotics. Copyright © The Author(s) 2022. |
| 546 ## - LANGUAGE NOTE | |
| Language note | English |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME | |
| Institution | MedStar National Rehabilitation Network |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME | |
| Institution | MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION | |
| Department | MedStar Georgetown University Hospital/MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION | |
| Department | Movement Disorders Fellowship |
| 656 ## - INDEX TERM--OCCUPATION | |
| Department | Multiple Sclerosis Fellowship Li |
| 656 ## - INDEX TERM--OCCUPATION | |
| Department | Neurology |
| 656 ## - INDEX TERM--OCCUPATION | |
| Department | Physical Medicine & Rehabilitation Residency |
| 657 ## - INDEX TERM--FUNCTION | |
| Medline publication type | Case Reports |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| Local Authors | Day, Derek |
| Institution Code | MNRH |
| Program | Physical Medicine & Rehabilitation Residency |
| Degree | MD |
| Resident year | Resident PGY 3 |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| Local Authors | Malla, Prerna |
| Institution Code | MWHC |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| Local Authors | Nagle, Brian |
| Institution Code | MGUH |
| Program | Movement Disorders Fellowship |
| Degree | MD, MPH |
| Resident year | Fellow PGY 5 |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| Local Authors | Safadi, Amy Li |
| Institution Code | MGUH |
| Program | Multiple Sclerosis Fellowship |
| Degree | MD |
| Resident year | Fellow PGY 5 |
| 790 ## - Authors | |
| All authors | Safadi AL, Day D, Nagle B, Di Maria G, Malla P |
| 856 ## - ELECTRONIC LOCATION AND ACCESS | |
| DOI | <a href="https://dx.doi.org/10.1177/19418744221075402">https://dx.doi.org/10.1177/19418744221075402</a> |
| Public note | https://dx.doi.org/10.1177/19418744221075402 |
| 858 ## - ORCID | |
| ORCID text | Safadi, Amy Li |
| Orcid | <a href="https://orcid.org/0000-0002-3610-4456">https://orcid.org/0000-0002-3610-4456</a> |
| Name | https://orcid.org/0000-0002-3610-4456 |
| 858 ## - ORCID | |
| ORCID text | Malla, Prerna |
| Orcid | <a href="https://orcid.org/0000-0001-5718-3272">https://orcid.org/0000-0001-5718-3272</a> |
| Name | https://orcid.org/0000-0001-5718-3272 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Koha item type | Journal Article |
| Item type description | Article |
No items available.