Syphilitic Meningitis

Written by Rachel Nall | Published on July 20, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Syphilitic Meningitis?

Syphilis is a sexually transmitted infection (STI). Left untreated, it can lead to meningitis. This is an infection of the layers of tissues that cover the brain and spinal cord. Syphilitic meningitis is also called syphilitic aseptic meningitis.

Syphilitic meningitis can be life threatening. However, it is preventable. Early diagnosis and treatment of syphilis can prevent this complication. It takes years, or even decades, for untreated syphilis to cause neurological disease.

What Are the Symptoms of Syphilitic Meningitis?

Meningitis refers to any inflammation of the meninges. These are the tissues that surround the brain. Bacteria, fungi, and viruses can all cause meningitis.

Syphilitic meningitis symptoms include:

  • vision changes, such as blurring or loss or vision
  • fever
  • headache
  • changes in mental status
  • nausea or vomiting
  • neck and shoulder pain and stiffness
  • unexplained fatigue
  • seizures
  • light and noise sensitivity
  • muscle aches
  • disinterest in eating or drinking

Advanced syphilis also can cause:

  • blindness
  • dementia
  • paralysis
  • numbness
  • death

What Causes Syphilitic Meningitis?

The bacterium Treponema pallidum causes syphilis. Many people have syphilis for years without noticeable symptoms. Because of this, it is often left untreated.

When syphilis is detected and treated promptly, complications are rare. Even without treatment, not everyone with syphilis will develop meningitis. It affects eight to forty percent of untreated patients (Birnbaum, et al., 1999). Furthermore, neurologic complications of syphilis usually do not occur until years, or even decades, after infection. A person might have syphilis for 10 to 20 years before meningitis occurs.

You are at greater risk for experiencing syphilitic meningitis if you have another STI. This is because having a different STI suggests that you have had unprotected sex. Unprotected sex is a major risk factor for syphilis. The disease can be spread through oral sex as well as vaginal and anal intercourse.

It is possible to transmit syphilis via nonsexual contact, although this is rare.

Also, you should note that if you have had syphilis in the past, you can get it again.

Tips to Prevent Syphilitic Meningitis

Syphilis is primarily spread through sexual contact. Consistently using protection during sex can prevent infection. This includes using barriers for oral sex.

If you are sexually active, regular STI testing is important. This aids in early syphilis diagnosis. A simple blood test can determine if you have syphilis. If detected early, it can be treated with one penicillin injection. This will prevent the development of meningitis.

Pregnant women should always be screened for syphilis. The condition can increase the risk of stillbirth. The infection can be passed from mother to child.

How Is Syphilitic Meningitis Diagnosed?

This condition is diagnosed with physical examinations and laboratory tests.

Examples of tests for meningitis include:

  • eye movement tests
  • imaging scans of the brain
  • spinal tap to test cerebrospinal fluid (CSF)
  • serum DRL or RPR to test for syphilis
  • blood culture to test for bacteria

Your physician may also test for other conditions that can cause similar symptoms, such as:

How Is Syphilitic Meningitis Treated?

If you are diagnosed with syphilitic meningitis, you will need to take antibiotics for several weeks.

Intravenous antibiotics will likely be used for a period of 10 to 14 days. After this, your physician may recommend weekly penicillin shots for another three weeks.

If you are allergic to penicillin, alternative antibiotics are available.

Curing the infection may not end your treatment. You may also need to address the life-threatening symptoms caused by infection. These include:

  • brain swelling
  • shock
  • dehydration
  • convulsions

Surgery may be needed to drain fluid in your brain or sinus cavities.

Complications of Syphilitic Meningitis and Your Outlook

If left untreated, syphilitic meningitis can quickly progress and cause death. It can cause brain and heart damage that can lead to stroke and seizures. Do not ignore your symptoms—death may occur only a few days after symptoms appear.

Some people recover fully from this condition. However, nerve damage can be permanent. In addition, syphilitic meningitis also puts you at greater risk for other infections, because it damages the immune system.

It may be a while before your doctor is certain whether any effects are permanent. Until then, you may require assistance with daily activities.

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