Syphilis is a sexually transmitted infection (STI) that can lead to meningitis if it’s left untreated. 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, but it’s preventable. Early diagnosis and treatment of syphilis can prevent this complication. It takes years, or even decades, for untreated syphilis to cause neurological disease.
Meningitis refers to any inflammation of the tissues that surround the brain, which are called the meninges. Bacteria, fungi, and viruses can all cause meningitis.
Syphilitic meningitis symptoms include:
- vision changes, such as blurring or loss or vision
- a fever
- a headache
- changes in mental status
- pain and stiffness in the neck and shoulders
- unexplained fatigue
- sensitivity to light and noise
- muscle aches
- a disinterest in eating or drinking
Advanced syphilis also can cause:
In some cases, advanced syphilis can even cause death.
The bacterium Treponema pallidum causes syphilis. Many people have syphilis for years without noticeable symptoms. Because of this, it’s 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 8 to 40 percent of untreated patients. Furthermore, the neurologic complications of syphilis usually don’t occur until years, or even decades, after infection. A person might have syphilis for 10 to 20 years before meningitis occurs.
You’re at greater risk of having syphilitic meningitis if you have another STI. This is because having an another STI suggests that you’ve 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’s possible to transmit syphilis through nonsexual contact, but this is rare.
Also, you should note that if you’ve had syphilis in the past, you can get it again.
This condition is diagnosed with physical examinations and laboratory tests.
Examples of tests for meningitis include:
- eye movement tests
- imaging scans of the brain
- a spinal tap to test cerebrospinal fluid
- the Venereal Disease Research Laboratory (VDRL) test for syphilis
- the rapid plasma reagin (RPR) test for syphilis
- a blood culture to test for bacteria
Your doctor may also test for other conditions that can cause similar symptoms like:
- Lyme disease
You’ll need to take antibiotics for several weeks if you’re diagnosed with syphilitic meningitis.
Intravenous antibiotics will likely be used for 10 to 14 days. After this, your doctor may recommend weekly penicillin shots for another three weeks.
If you’re 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
Surgery may be needed to drain fluid from your brain or sinus cavities.
If it’s left untreated, syphilitic meningitis can quickly progress and cause death. It can cause brain and heart damage that can lead to stroke and seizures. Don’t ignore your symptoms. Death may occur only a few days after the symptoms appear.
Some people recover fully from this condition. However, nerve damage can be permanent. 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 need help with daily activities.
Syphilis primarily spreads through sexual contact. Consistently using protection during sex can prevent infection. This includes using barriers for oral sex.
If you’re sexually active, regular STI testing is important. This aids in early syphilis diagnosis. A simple blood test can determine if you have syphilis. If it’s detected early, it can be treated with one penicillin injection. This will prevent the development of meningitis.
If you’re pregnant, you should be screened for syphilis. The condition can increase the risk of stillbirth, and the infection can be passed from you to your child.