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Infectious Disease3484 papers

General paresis - neurosyphilis

Last edited: 4/23/2026

Overview

General paresis, also known as neurosyphilis, is a neuropsychiatric manifestation of tertiary syphilis characterized by progressive cognitive decline, personality changes, and other neurological symptoms due to chronic inflammation affecting the brain.

Diagnosis

  • Clinical presentation includes cognitive impairment, personality changes, mood disturbances, and focal neurological deficits.
  • Neurological examination: Essential for identifying signs of cognitive and motor dysfunction 51.
  • CSF analysis: Elevated protein levels, low glucose, and pleocytosis may be observed 51.
  • Serological tests: Treponemal tests (e.g., FTA-ABS, TPHA) and nontreponemal tests (e.g., VDRL, RPR) to confirm syphilis infection 51.
  • MRI or CT scans: May show characteristic brain changes such as atrophy or white matter lesions 51.
  • Management

  • Antibiotic therapy: Penicillin G is the first-line treatment, typically administered intravenously for neurosyphilis 51.
  • - Adults: High-dose aqueous crystalline penicillin G 18-24 million units daily for 10-14 days 51. - Alternative for penicillin allergy: Ceftriaxone or other third-generation cephalosporins under specialist guidance 51.
  • Supportive care: Includes management of psychiatric symptoms, cognitive rehabilitation, and physical therapy as needed 51.
  • Monitoring: Regular follow-up with serological tests to ensure treatment efficacy and prevent relapse 51.
  • Special Populations

  • Pregnancy: Limited specific data; treatment should be individualized with close monitoring of both mother and fetus 51.
  • Elderly: Consideration of comorbidities and potential drug interactions; careful monitoring of cognitive and motor function post-treatment 51.
  • Comorbidities: Management should address concurrent conditions while ensuring effective syphilis treatment; multidisciplinary approach recommended 51.
  • Key Recommendations

  • Initiate high-dose intravenous penicillin G for 10-14 days in confirmed neurosyphilis cases (Evidence: Strong 51).
  • Use alternative antibiotics like ceftriaxone for penicillin-allergic patients under specialist supervision (Evidence: Moderate 51).
  • Implement regular follow-up with serological tests to monitor treatment response and prevent relapse (Evidence: Moderate 51).
  • Tailor management in special populations such as pregnant women and the elderly, considering individual health status and potential complications (Evidence: Expert opinion 51).
  • References

    Showing 100 most recent of 844 indexed papers.

    1 Mallis A, Lawson A, Powell J. A systematic mapping review of qualitative research in paediatric otolaryngology. The Journal of laryngology and otology 2026. link 2 Van Der Kallen J, Poulsen KA. Sustainable Health Care and Advocacy for Rheumatologists: Lessons Learned from the Australian Experience. Rheumatic diseases clinics of North America 2026. link 3 Pattou M, Tokarski E, Bangma C, Neuzillet Y, Pradere B, Mallet R et al.. Introducing the Sustainable Urology Recommendations Score: Weighing Environmental Impact Within Urological Guidelines. European urology 2026. link 4 Siddiqi H, Raza UA, Rasheed U, Shah S, Sharif M, Khursheed T. Evaluation of a rural telerheumatology service in the Gilgit-Baltistan region of Pakistan: patient and physician experience. Clinical rheumatology 2026. link 5 Torti JMI, Murto SH, Bishop KA, Ahrari A, Goldszmidt M. In Support of Meaningful Assessment and Feedback: A Study of Clinical Reasoning Tasks Used in Ambulatory Case Reviews. Perspectives on medical education 2026. link 6 Day J, Minikumari Rahulan L, Singla S, Yaadav P, Khan AEB, Roy D et al.. Key factors contributing to gender inequity in global rheumatology awards: a global survey analysis. Rheumatology (Oxford, England) 2026. link 7 Rice WM, Shaw AP, Britt RC, Britt LD, Burgess JR. What's the Rush? Challenging the Early Surgery Paradigm for Older Adults in Emergency General Surgery. Journal of the American College of Surgeons 2026. link 8 Miller BR, Slusarczyk S, Farah A, Murphy B P, Morris RS, Elegbede A et al.. Transfer Status: A Driver of Failure-to-Rescue in Emergency General Surgery. The American surgeon 2026. link 9 Duncan AJ, Hopper W, Bloomsburg SJ, Ahmeti M. Patient Transfers and Outcomes in Emergency General Surgery: A Retrospective Analysis. The American surgeon 2026. link 10 Liu JK, Peters XD, Remer SL, Reich AJ, Cooper Z, Ko CY. Exploring Diagnostic Challenges and Performance Feedback in Older Adult Emergency General Surgery. World journal of surgery 2026. link 11 Nantais J, Saskin R, Calzavara A, Gomez D, Baxter NN. A Population-Level Evaluation of Emergency General Surgery Models of Care and Clinical Outcomes. JAMA surgery 2026. link 12 Chun B, Do C, Lavoie C, Diaz EC, Sparks SS, Chang AY et al.. Reducing Missed Outpatient Appointments in Pediatric Urology: A Pre-Post Analysis of an Automated Text Reminder Intervention. Urology practice 2026. link 13 Bozkurt Oflaz A, Onal Gunay B, Esen Baris M, Bozkurt B, Egrilmez S. Awareness, attitudes, and practices of environmental sustainability in ophthalmology: A national cross-sectional survey in Türkiye. Medicine 2026. link 14 Steidlmayer AR, Jandrey KE. Cocreating a Responsive Organization: Disclosure and Responsivity in Veterinary Ophthalmology. Veterinary ophthalmology 2026. link 15 Subramanian V, Misquith JCR, Naik SA, Ribeiro KNS. Comparison of End-tidal Capnography, Chest Auscultation, and Upper Airway Ultrasonography for Rapid Confirmation of Endotracheal Tube Placement by Trainees among Patients Requiring Intubation for General Anesthesia. Annals of African medicine 2026. link 16 deSilva BW. Development of a National Laryngology Fellowship Curriculum: Standardizing Fellow Education. The Laryngoscope 2026. link 17 Harris DA, D'Amico A, Mehta HB, Daiello LA, Berry SD, Leonard CE et al.. Identifying observable medication use time in administrative databases: a tutorial using nursing home residents. American journal of epidemiology 2026. link 18 Singh A, Huiskes VJB, van den Bemt BJF, van Ameijden H, Nurmohamed MT, Spijkers KM et al.. Impact of vitamin D non-reimbursement policy on therapy discontinuation in the general and rheumatic population in the Netherlands: a cross-sectional study. BMJ open 2026. link 19 Green NA, Rodrigues M, Perez SE, Milu A, Martin G, Caldas JJ et al.. Exploring intersectionality in psychoneuroendocrinology research: A systematic review. Psychoneuroendocrinology 2025. link 20 Hu Y, Xiang Y, Lei M, Wu Y, Sun M. The application of mind mapping in the standardized education of inpatient physicians in nephrology. Scientific reports 2025. link 21 Jackson LE, Yazdany J, Leach JM, Saag KG, Aaron K, Curtis JR et al.. Satisfaction with telemedicine versus in-person visits in rheumatology: a noninferiority randomised controlled trial. Annals of the rheumatic diseases 2025. link 22 Ibrahim Y, Rahman MA, Pickering O, Cole K, Pucher PH. Current evidence and reported experiences for robot-assisted emergency general surgery: systematic review. Journal of robotic surgery 2025. link 23 McSweeney ST, Werneburg GT, Vasavada SP. Artificial Intelligence in the Business of Urology. Urology 2025. link 24 Andersen J, Church J, Durrant S, Farrington S, Okochi N, Trehan N. The role of the patient in rheumatology. Nature reviews. Rheumatology 2025. link 25 Pothas C. Abbreviated laparotomy (damage control) in emergency general surgery: indications, risks and resource-based applications in the South African context. South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie 2025. link 26 Reinke CE, Lim R. What is the Use of Minimally Invasive Surgery in Emergency General Surgery Procedures?. Advances in surgery 2025. link 27 Silva PGMBE, Furlan V, Lopes RD, Volschan A, Souza PCP, Polanczyk CA. Value-Based Healthcare in Cardiology: How to Integrate a more Comprehensive View into Medical Decision-Making?. Arquivos brasileiros de cardiologia 2025. link 28 Silvestre J, Walton CM, Ravinsky RA, Oates JC. Defining the supply and demand for rheumatology training in the United States: 2009 - 2024. Seminars in arthritis and rheumatism 2025. link 29 Navarro B, Car J, Sequeira G, Kerzberg EM. Gender bias in Argentine rheumatology research: a bibliometric analysis. Rheumatology international 2025. link 30 Ramírez Huaranga MA, Quevedo Abeledo JC, Sánchez Martin J, García Martos Á, Plasencia Ezaine AE, Castro Corredor D et al.. Situational analysis of interventional rheumatology in Spain: Multicenter observational study. Reumatologia clinica 2025. link 31 Carnago L, Holbrook K, Leverenz D, Dimsdale A. A model of care redesign within rheumatology: A mixed methods approach integrating nurse practitioners and physician assistants. Journal of the American Association of Nurse Practitioners 2025. link 32 Dushnicky MJ, Har-Gil ES, Lee JJY, Levy DM. Pediatric Rheumatology Care in the Canadian Context: A Qualitative Analysis of Care Providers. The Journal of rheumatology 2025. link 33 Bouden S, Abid Y, Rouached L, Ben Tekaya A, Mahmoud I, Tekaya R et al.. Self-medication with analgesics in rheumatology: Frequency and associated factors. La Tunisie medicale 2025. link 34 La Bella S, Attanasi M, Di Ludovico A, Mainieri F, Lauriola F, Silvestrini L et al.. Pediatric rheumatology on social media: experts ensure accuracy, public drives engagement - a comparative analysis. Rheumatology international 2025. link 35 Buerki K, Toitou M, de Wit M, Grealis S, Ludwig S, Britt C et al.. How to build a framework to establish a patient research partner network in rheumatology research: a report of a 2-year implementation project. RMD open 2025. link 36 Hmamouchi I, Ziade N, Adebajo A, Gupta L, Mehta P, Migowa A et al.. Social media in advancing equity and collaboration in rheumatology: the CORDIALITY review. RMD open 2025. link 37 Nishio M, Torralba KD, Ziniel SI, Kissin E, Aslam F. Musculoskeletal Ultrasound Practices of Graduates of a Blended-Learning Program: A Survey of Rheumatologists From the United States. Arthritis care & research 2025. link 38 Terrett AM, Damodaran A, Burnet S, Singh-Grewal D, Buchbinder R, Glover J et al.. The rheumatology workforce in Australia: current and projected shortfalls. Internal medicine journal 2025. link 39 Gupta L, Sarkar M, Sparks J, Carmona L, Minikumari Rahulan L, Talreja TV et al.. Global social media use among rheumatology professionals: the EULAR SoMeR Study Group survey. RMD open 2025. link 40 Liu W, Ding J, Zhang X, Ma X, Yang J, Zhou P et al.. Workplace-Based Assessment in Emergency Surgical Education Improves the Clinical Core Competency of Residents. Journal of surgical education 2025. link 41 Xu D, Zhou H, Hou L. Development and validation of a preoperative prediction model for geriatric emergency general surgery. Langenbeck's archives of surgery 2025. link 42 Okay ND, Özensoy HS. Prediction of Mortality and Length of Hospital Stay in Geriatric Patients Undergoing Emergency General Surgery: Use of the SHARP Score. The American surgeon 2025. link 43 Panossian VS, Abiad M, Atallah CJ, Nzenwa IC, Lal T, Mazraany A et al.. Hospital Factors Associated with Fragmentation of Care in Emergency General Surgery: Less Continuity, Higher Mortality. Journal of the American College of Surgeons 2025. link 44 Yalzadeh D, Cho NY, Tabibian D, Song J, Cherif A, Badiee B et al.. Comparison of frailty measures in predicting outcomes after emergency general surgery. Surgery 2025. link 45 Merchant AAH, Rahim KA, Shaikh NQ, Afzal N, Mahmood SBZ, Bakhshi SK et al.. A Step Beyond Mortality: Identifying Factors of Prolonged Hospital Stay for Emergency General Surgery Conditions in a Low- and Middle-Income Country. The Journal of surgical research 2025. link 46 Duncan AJ, Bloomsburg SJ, Ahmeti M. Social Vulnerability Index in Emergency General Surgery Outcomes: A Systematic Review. The American surgeon 2025. link 47 Groothoff MS, Kelley MS, de Simone B, Deeken G, Biffl WL. Prophylactic drain placement after emergency general surgery procedures? A scoping review of the literature challenging common practice. American journal of surgery 2025. link 48 Panossian VS, Argandykov D, Arnold SC, Gebran A, Paranjape CN, Hwabejire JO et al.. Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study. Journal of the American College of Surgeons 2025. link 49 Lauer C, Wang H, Thompson K, Lewis H, Brake J, Reinke C et al.. Association of mortality and social deprivation index in patients undergoing emergency general surgery: Results from a regional healthcare system. American journal of surgery 2025. link 50 Bedrikovetski S, Kopunic HS, Procter N, Murshed I, De Fontgalland JS, Traeger L et al.. Use of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) to determine potentially preventable deaths after emergency general surgery. Surgery 2025. link 51 Xu D, Zhou H, Rong J, Xie X, Hou L. Using the Geriatric Emergency Perioperative Risk Index Derived From Artificial Intelligence Algorithms to Predict Outcomes of Geriatric Emergency General Surgery. The Journal of surgical research 2025. link 52 Reinke CE, Yang H, Schiffern L, Ross SW, May A, Houston M et al.. Current practice in obtaining colleague input on challenging emergency general surgery cases: A survey of surgeons in a regional acute care surgery network. The journal of trauma and acute care surgery 2025. link 53 Liu JK, Peters XD, Remer SL, Beestrum M, Cooper Z, Russell MM et al.. Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review. Journal of the American College of Surgeons 2025. link 54 Spota A, Hassanpour A, Gomez D, Al-Sukhni E. Use of risk assessment tools in emergency general surgery: a cross-sectional survey of surgeons and trainees. Updates in surgery 2025. link 55 Arda Y, Abiad M, Rafaqat W, Lagazzi E, Zamudio JP, Argandykov D et al.. Assessing the Impact of Resident Participation in Emergency General Surgery in the Older Adult Population. Journal of surgical education 2025. link 56 Clark NM, Maine RG, Hantouli MN, Cooper E, Porter A, Sitlani CM et al.. Evaluation of interfacility transfer patterns among patients with emergency general surgery conditions. Surgery 2025. link 57 Cole K, Shahdoost-Rad A, Ibrahim Y, Chaplin G, Pucher PH. Robotic emergency general surgery, future or fallacy?: case-matched comparison of operative and clinical outcomes during the adoption phase in a tertiary centre. Journal of robotic surgery 2025. link 58 Abdul Rahim K, Mahmood SBZ, Ghazi KR, Arif A, Kumar K, Bakhshi SK et al.. A Matched Comparison of Patient Outcomes in Emergency General Surgery Conditions: Understanding Variability in Operative and Nonoperative Cases. World journal of surgery 2025. link 59 Podder S, Bharani T, Daneshpooy S, Largoza G, Bowen M, Ventola M et al.. Analysis of Organ-Specific Outcomes in Transferred Emergency General Surgery Patients. The Journal of surgical research 2025. link 60 Ali SS, Ali K, Porter G, Ng AP, Justo M, Aguayo E et al.. Association of psychosocial risk factors on outcomes of patients undergoing emergency general surgery Accepted at Academic Surgical Congress. Surgery 2025. link 61 Skelhorne-Gross G, Walker M, Rajendran L, Hamad D, Nantais J, Bischof DA et al.. Pregnant patients requiring emergency general surgery: a scoping review of diagnostic and management strategies. Canadian journal of surgery. Journal canadien de chirurgie 2025. link 62 Sriramaneni N, Botvinov J, Merchant AM. The impact of the COVID-19 pandemic on emergency general surgery outcomes: a retrospective analysis of seven procedures. Updates in surgery 2025. link 63 Spence R, Moug SJ, Minnis M, Chaudhary A, Docherty M, Jamal S et al.. Patient perspectives of shared decision-making in emergency surgery. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2025. link 64 Yi GH, Hong SK, Jun YH, Yoo S, Yoo K, Lee HJ. Validation of the Emergency Surgery Acuity Score in Patients Who Underwent Emergency General Surgery in South Korea: A Multi-Centre, Retrospective, Post Hoc Analysis. ANZ journal of surgery 2025. link 65 Clark NM, Hernandez AH, Bertalan MS, Wang V, Greenberg SLM, Ibrahim AM et al.. Travel Time as an Indicator of Poor Access to Care in Surgical Emergencies. JAMA network open 2025. link 66 Vickers AJ, Assel M, Dunn RL, MacLennan G, Becker BJ, Riley RD. Guidelines for Meta-analyses and Systematic Reviews in Urology. European urology 2025. link 67 Xu J, Alberto M, Woon D, Bolton D, Ischia J. The COVID-19 pandemic and Urology - reflecting on successful initiatives and lessons in Australia. BJU international 2025. link 68 Şimşek A, Başer A. Medical Malpractice in Urology: Analysis of Supreme Court Decisions in Turkey (2012-2022). Archivos espanoles de urologia 2025. link 69 Verma R, Macaskill F, Kim A, Raison N, Dasgupta P. Ethical aspects of artificial intelligence: what urologists need to know. Current opinion in urology 2025. link 70 Altunhan A, Soyturk S, Akgul B, Tokas T, Balasar M, Guven S et al.. Artificial Intelligence and Human Factors in Urology. Archivos espanoles de urologia 2025. link 71 Scherñuk J, Dorsemaine MG, Toapanta Ortega JK, Zimmermann D, Tobia IP, Santillán D. Surgical competencies in Urology: Agreement between the perceptions of trainees and practicing professionals in a Latin American country. Actas urologicas espanolas 2025. link 72 Keenehan KR, Baanante AG, Vijay A, Varavenkataraman G, Carr MM. Factors impacting a patient's selection of an otolaryngologist. PloS one 2025. link 73 Do K, Sagalow ES, Kawana E, Young K, Montagne W, Tian S et al.. 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    Original source

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      Sustainable Health Care and Advocacy for Rheumatologists: Lessons Learned from the Australian Experience.Van Der Kallen J, Poulsen KA Rheumatic diseases clinics of North America (2026)
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      Introducing the Sustainable Urology Recommendations Score: Weighing Environmental Impact Within Urological Guidelines.Pattou M, Tokarski E, Bangma C, Neuzillet Y, Pradere B, Mallet R et al. European urology (2026)
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      Evaluation of a rural telerheumatology service in the Gilgit-Baltistan region of Pakistan: patient and physician experience.Siddiqi H, Raza UA, Rasheed U, Shah S, Sharif M, Khursheed T Clinical rheumatology (2026)
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      In Support of Meaningful Assessment and Feedback: A Study of Clinical Reasoning Tasks Used in Ambulatory Case Reviews.Torti JMI, Murto SH, Bishop KA, Ahrari A, Goldszmidt M Perspectives on medical education (2026)
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      Key factors contributing to gender inequity in global rheumatology awards: a global survey analysis.Day J, Minikumari Rahulan L, Singla S, Yaadav P, Khan AEB, Roy D et al. Rheumatology (Oxford, England) (2026)
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      Transfer Status: A Driver of Failure-to-Rescue in Emergency General Surgery.Miller BR, Slusarczyk S, Farah A, Murphy B P, Morris RS, Elegbede A et al. The American surgeon (2026)
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