Abstract
Neurosyphilis is caused by the spirochete Treponema pallidum, with an incidence of 0.47-2.1 cases per 100,000 inhabitants, can generate neuroinvasion from early stages of the infection. It is known as "the great simulator", with manifestations that include cases asymptomatic, parenchymal compromises (encephalic and / or spinal cord) or meningeal involvement with associated vascular damage. Diagnosis is based primarily on treponemal tests and not treponemal, both serum and cerebrospinal fluid (CSF). Here a positive VDRL is the most specific test for diagnosis, however, having limited sensitivity, certain cytochemical changes in an appropriate clinical context allow suspicion of the disease. HIV patients pose a special challenge. Treatment with Crystalline Penicillin continues being the first therapeutic option at doses of 3-4 million units IV every 4 hours or 24 million units in continuous infusion for 10 to 14 days. In some cases it is required desensitization or alternative regimens. The Jarisch-Herxheimer reaction secondary to Antibiotic treatment is unpredictable and can lead to serious complications. recommends Prednisolone 40-60 mg a day for 3 days, starting 24 hours before the first dose of antibiotic therapy. CSF monitoring is often useful and necessary.
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