Neurosyphilis presenting as psychiatric symptoms: an unusual case report

2007 ◽  
Vol 19 (4) ◽  
pp. 251-253 ◽  
Author(s):  
Hasan Mirsal ◽  
Ayhan Kalyoncu ◽  
Özkan Pektaş ◽  
Mansur Beyazyürek
Keyword(s):  
Psychiatric Symptoms ◽  
Treponema Pallidum ◽  
Antibody Test ◽  
Risk Groups ◽  
Serological Tests ◽  
Case Presentation ◽  
Antibody Absorption ◽  
Gradual Loss ◽  
Neuropsychiatric Diseases ◽  
Organic Brain

Objective:Neurosyphilis remains a differential diagnosis for a wide variety of psychiatric syndromes, including dementia, mood disorders and psychosis. However, the incidence of neurosyphilis presenting initially with psychiatric symptomalogy is unclear. In this article, a clinical case is reported so as to illustrate some of the issues involved.Case presentation:A 33-year-old married man was admitted because of a depressive episode associated with somatic preoccupations and a gradual loss of ability to function a year prior to his admission. The symptoms described above raised the question of an organic brain syndrome associated with the psychotic depression. Some laboratory and additional examinations were performed. Serological tests for syphilis were positive for both the hemagglutination test, Treponema pallidum hemaglutination (TPHA), and the immunofluorescent antibody test, fluorescent treponemal antibody-absorption (FTA-ABS). Based on these findings, the diagnosis of neurosyphilis was made. The patient was treated with benzathine penicillin (2 400 000 units i.m. once a week) for 3 weeks and venlafaxine (150 mg daily) and olanzapine (5 mg daily). His depression disappeared gradually, and he was discharged in partial remission.Conclusion:High-risk groups such as patients with neuropsychiatric diseases should be screened with serological tests so as to prevent morbidity and help eliminate syphilis.

scholarly journals Defibrination of Blood Plasma for Use in Serological Tests for Syphilis

2002 ◽  
Vol 9 (6) ◽  
pp. 1376-1378 ◽  
Author(s):  
Arnold R. Castro ◽  
Susan E. Kikkert ◽  
Martha B. Fears ◽  
Victoria Pope
Keyword(s):  
Treponema Pallidum ◽  
The United States ◽  
Reactivity Index ◽  
Plasma Samples ◽  
Serological Tests ◽  
Antibody Absorption ◽  
Initial Plasma ◽  
General Decline ◽  
Control And Prevention ◽  
Human Sera

ABSTRACT Syphilitic plasma can be salvaged from discarded blood donations and converted to serum by defibrination. Sixty-nine units of plasma were treated with a stock solution of 100 U of thrombin per ml in 1 M calcium chloride and then with a 10% (wt/vol) solution of kaolin. Fibrinogen concentrations detected in initial plasma samples ranged from 94 to 4,970 mg/liter (mean, 2,532 mg/liter) for samples that were reactive by the rapid plasma reagin circle card test (RPR) and from 314 to 2,742 mg/liter (mean 1,528 mg/liter) for samples that were not reactive by the RPR. The treated samples showed no measurable fibrinogen remaining after the defibrination process. In the nontreponemal RPR for syphilis, 86% of the treated plasma samples retained the same endpoint titer as that of the initial plasma sample. When the Treponema pallidum passive-particle-agglutination test was used, 98% retained the same reactivity. In the Captia Syphilis-G enzyme immunoassay, 89% of the treated samples demonstrated no change in reactivity index, and in the fluorescent treponemal antibody absorption test, 96% showed no reduction in fluorescence. Human sera containing antibodies to syphilis are used at the Centers for Disease Control and Prevention for the preparation of reference controls or as samples for proficiency testing. Finding reactive sera is becoming more difficult due to the general decline of syphilis cases in the United States. The decreasing availability of these sera can be alleviated by salvaging plasma and converting it to serum.

scholarly journals Celiac Disease Revisited

2021 ◽  
pp. 1-14
Author(s):  
João Calado ◽  
Mariana Verdelho Machado
Keyword(s):  
Celiac Disease ◽  
Systemic Disease ◽  
Human Leukocyte ◽  
Risk Groups ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Serological Tests ◽  
Leukocyte Antigen ◽  
Human Leukocyte Antigen Haplotype ◽  
Circulating Autoantibodies

Celiac disease (CD) is a systemic disease triggered by gluten ingestion in genetically predisposed individuals. It manifests primarily as an autoimmune enteropathy associated with specific circulating autoantibodies and a human leukocyte antigen haplotype (HLA-DQ2 or HLA-DQ8). It afflicts roughly 1% of the population, though the majority of patients remain undiagnosed. Diarrhea and malabsorption are classic manifestations of CD; however, both children and adults can be paucisymptomatic and present extraintestinal manifestations such as anemia, osteoporosis, and abnormal liver tests. CD screening is not recommended for the general population, and it should be focused on high-risk groups. CD diagnosis is challenging and relies on serological tests, duodenal histology, and genetic testing. Particularly difficult presentations to manage are seronegative patients, seropositive patients without villus atrophy, and patients who have started a gluten-free diet before the diagnostic workup. The only proven treatment is a lifelong gluten-free diet. We present an in-depth review on the physiopathology and management of CD, with a particular emphasis on diagnostic challenges.

scholarly journals Occurrence of antibodies against Neospora caninum and/or Toxoplasma gondii in dogs with neurological signs

2011 ◽  
Vol 20 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Nicolle Fridlund Plugge ◽  
Fabiano Montiani Ferreira ◽  
Rosária Regina Tesoni de Barros Richartz ◽  
Adriana de Siqueira ◽  
Rosangela Locatelli Dittrich
Keyword(s):  
Toxoplasma Gondii ◽  
Neospora Caninum ◽  
Neurological Diseases ◽  
Fluorescent Antibody ◽  
Antibody Test ◽  
Metropolitan Region ◽  
Serological Tests ◽  
Stray Dogs ◽  
Neurological Signs ◽  
Significant Difference

This study aimed to evaluate occurrences of antibodies against Neospora caninum and Toxoplasma gondii in dogs with neurological signs. Blood samples from 147 dogs were collected: 127 from owned dogs (attended at the Veterinary Teaching Hospital of the Federal University of Paraná (HV-UFPR) and at private veterinary clinics in the city of Curitiba), and 20 from stray dogs found in Curitiba's metropolitan region. The dogs presented one or more of the following neurological signs: seizures, paresis or paralysis, ataxia, behavioral abnormalities, sensory and somatic disorders and chorioretinitis. The samples were analyzed by means of the indirect fluorescent antibody test (IFAT), at a cutoff dilution of 1:50. Out of the 147 samples obtained, 17 (11.56%) were seropositive for N. caninum, 31 (21.08%) for T. gondii and four (2.72%) for both protozoa. Serum titration on the positive animals showed that 54.83% (17/31) and 41.18% (7/17) had titers > 1:200 against T. gondii and N. caninum, respectively. A significant difference in seropositivity for T. gondii (P = 0.021; OR = 2.87; CI = 1.1 > 2.8 > 7.4) was observed between owned dogs (18.11%) and stray dogs (40%). Inclusion of serological tests for neosporosis and toxoplasmosis is recommended in diagnosing neurological diseases in dogs.

scholarly journals Penile Mondor’s in a Covid-19 patient on prophylactic anti-thrombosis with rivaroxaban: a case report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Murat Tuğrul Eren ◽  
Hakan Özveri ◽  
Hilal Kurtoğlu
Keyword(s):  
Male Patient ◽  
Antibody Test ◽  
Inflammatory Cells ◽  
Thromboembolism Prophylaxis ◽  
Case Presentation ◽  
Subacute Phase ◽  
Dorsal Vein ◽  
Wide Range ◽  
Underlying Causes

Abstract Background Penile Mondor’s disease (PMD) is thrombophlebitis of the superficial dorsal vein of the penis. Following the occurrence of thrombotic events in the affected veins, the lumen often becomes occluded with fibrin and inflammatory cells. A hyper-coagulative state is one of the underlying causes although most cases of PMD are idiopathic. Coronavirus disease-2019 infection (COVID-19) is associated with frequent thrombotic events. Inflammation and thrombosis play a central role in the course and outcome of COVID-19, which can predispose to both venous and arterial thromboembolism. In this report, we present a 33-year-old male patient diagnosed with PMD during the subacute phase of COVID-19 infection while on prophylactic antithrombotic treatment. Case Presentation A 33-year-old male patient was diagnosed as PMD which occurred during the subacute phase of COVID-19 infection, while he was on active treatment of COVID-19 by prophylactic antithrombotic Rivaroxaban 15 mg therapy and curative antiviral medication. There was no recent sexual intercourse or trauma to the genitals. His PCR test for COVID-19 had become negative, and antibody test was positive at the time of his PMD’s onset. Rivaroxaban was replaced by Enoxaparin (8000 IU/0.8 ml.), a low molecular weight heparin administered subcutaneously and twice daily. On the third day of this medication, all coagulative measurements returned to normal. PMD disappeared in the second week. Conclusion Low-dose Rivaroxaban 15 mg is not safe for some COVID-19-associated thromboembolism prophylaxis, and careful follow-up is critical due to the possibility of a wide range of pathologic thrombotic manifestations in COVID-19 infection.

scholarly journals Occurrence of Lutzomyia longipalpis (Phlebotominae) and canine visceral leishmaniasis in a rural area of Ilha Solteira, SP, Brazil

2014 ◽  
Vol 23 (4) ◽  
pp. 456-462 ◽  
Author(s):  
Julio Cesar Pereira Spada ◽  
Diogo Tiago da Silva ◽  
Kennya Rozy Real Martins ◽  
Lílian Aparecida Colebrusco Rodas ◽  
Maria Luana Alves ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Rural Area ◽  
Antibody Test ◽  
Lutzomyia Longipalpis ◽  
Climatic Data ◽  
Canine Visceral Leishmaniasis ◽  
Serological Tests ◽  
Relative Air Humidity ◽  
Control And Prevention ◽  
One Year

This study aimed to investigate the occurrence of Lutzomyia longipalpis and also the canine visceral leishmaniasis (CVL) in a rural area of Ilha Solteira, state of São Paulo. Blood samples were collected from 32 dogs from different rural properties (small farms) and were analyzed by ELISA and the indirect immunofluorescence antibody test (IFAT) in order to diagnose CVL. From these serological tests, 31.25% of the dogs were positive for CVL and these were distributed in 66.7% (8/12) of the rural properties, which were positive for L. longipalpis. CDC (Center for Disease Control and Prevention) light traps were installed in 12 properties (one per property) and insects were caught on three consecutive days per month for one year. L. longipalpis was present on 100% of the rural properties visited, at least once during the twelve-month interval, totaling 64 males and 25 females. The insects were more numerous after the peak of the rain, but the association between prevalence of peridomestic vectors and the climatic data (precipitation, relative air humidity and temperature) and the occurrences of CVL among dogs on each rural property were not statistical significant (p <0.05). However, the occurrence of CVL cases in dogs and the presence of L. longipalpis indicate that more attention is necessairy for the control of this disease in the rural area studied.

scholarly journals Evaluation of the fluorescent gonococcal test-heated

1976 ◽  
Vol 4 (5) ◽  
pp. 423-428
Author(s):  
H A Gaafar
Keyword(s):  
Indirect Fluorescent Antibody Test ◽  
Fluorescent Antibody ◽  
Clinical Signs ◽  
Antibody Test ◽  
Signs And Symptoms ◽  
Risk Groups ◽  
Indirect Fluorescent Antibody ◽  
Culture History ◽  
History Of ◽  
Clinical Signs And Symptoms

In a 1-year evaluation of the indirect fluorescent antibody test for gonorrhea, 16,127 specimens from low-and high-risk groups were examined, and the results were compared with culture, history of exposure to a known patient, and clinical signs and symptoms. The results confirmed the usefulness of the indirect fluorescent antibody test for gonorrhea as a screening procedure, especially for women in the low-risk group. The test is more economic and probably more sensitive than culture for mass screening of asymptomatic women.

scholarly journals Correlation of the commercial anti-SARS-CoV-2 receptor binding domain antibody test with the chemiluminescent reduction neutralizing test and possible detection of antibodies to emerging variants

2021 ◽  
Author(s):  
Yoshitomo Morinaga ◽  
Hideki Tani ◽  
Yasushi Terasaki ◽  
Satoshi Nomura ◽  
Hitoshi Kawasuji ◽  
...  
Keyword(s):  
Receptor Binding ◽  
Disease Onset ◽  
Antibody Test ◽  
Binding Domain ◽  
Receptor Binding Domain ◽  
Healthy Individuals ◽  
Wild Type ◽  
Serum Samples ◽  
Serological Tests ◽  
Convalescent Phase

Background Serological tests are beneficial for recognizing the immune response against SARS-CoV-2. To identify protective immunity, optimization of the chemiluminescent reduction neutralizing test (CRNT), using pseudotyped SARS-CoV-2, is critical. Whether commercial antibody tests are comparably accurate is unknown. Methods Serum samples collected before variants were locally found were obtained from confirmed COVID-19 patients (n = 74), confirmed non-COVID-19 individuals (n = 179), and unscreened individuals (suspected healthy individuals, n = 229). The convalescent phase was defined as the period after day 10 from disease onset. The CRNT against pseudotyped viruses displaying the wild-type spike protein and a commercially available anti-receptor binding domain (RBD) antibody test were assayed. The CRNT was also assayed, using South African (SA) and United Kingdom (UK)-derived variants. Results The CRNT (cut off value, 50% inhibition) and the anti-RBD antibody test (cut off value, 0.8 U/mL) concurred regarding symptomatic COVID-19 patients in the convalescent phase and clearly differentiated between patients and suspected healthy individuals (sensitivity; 95.8% and 100%, specificity; 99.1% and 100%, respectively). Anti-RBD antibody test results correlated with neutralizing titer (r = 0.47, 95% CI 0.20-0.68). Compared with the wild-type, CRNT reduction was observed for the SA and UK-derived variants. Of the samples with ≥100 U/mL by the anti-RBD antibody test, 77.8% and 88.9% showed ≥50% neutralization against the UK and the SA variants, respectively. Conclusion The CRNT and commercial anti-RBD antibody test effectively classified convalescent COVID-19 patients. The strong positive results using the commercial antibody test can reflect neutralizing activity against emerging variants.

Is Toxoplasma gondii Infection a Cause or a Coincidence in an Adolescent with Psychosis?

2020 ◽  
Author(s):  
Hüsniye Yucel ◽  
Burak Acikel ◽  
F Nur Öz ◽  
Saliha Senel
Keyword(s):  
Toxoplasma Gondii ◽  
Psychiatric Symptoms ◽  
Current Level ◽  
Neuropsychiatric Diseases ◽  
New Knowledge ◽  
Young Adolescent Girl ◽  
Toxoplasma Gondii Infection ◽  
Psychiatric Problems ◽  
Immunocompetent Patients

AbstractAlthough presumed to be relatively harmless in immunocompetent patients, toxoplasmosis has been linked to several psychiatric problems such as schizophrenia, bipolar disorder, and suicidal/aggressive behaviors. We describe an 11-year-old young adolescent girl with psychoses who was ultimately diagnosed with toxoplasmosis. It is an unusual presentation of Toxoplasma gondii infection that adds new knowledge to the current level of literature about the substantial role of Toxoplasma gondii in the etiology of neuropsychiatric diseases. We propose that screening for toxoplasmosis is needed besides other etiologies in differential diagnosis of psychiatric symptoms particularly in endemic areas.

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