Syphilitic aseptic meningitis is a complication of untreated syphilis that involves inflammation of the tissues covering the brain and spinal cord. The condition is marked by changes in mental status and problems with nerve function.

Syphilitic aseptic meningitis is a form of meningovascular neurosyphilis, which is a progressive life-threatening complication of syphilis infection.

The disorder resembles meningitis caused by other conditions. There is inflammation of the meninges (the membranes that cover the brain and spinal cord). This may cause headaches, cognitive changes, or decrease in nerve functions such as vision, movement, or sensation. Vascular (blood vessel) symptoms, such as stroke secondary to syphilis, commonly accompany or follow syphilitic aseptic meningitis.

Risks of syphilitic aseptic meningitis include previous infection with syphilis or other sexually transmitted diseases such as gonorrhea (which may hide symptoms of syphilis infection). Syphilis infections are transmitted primarily through sexual contact with an infected person, but they may sometimes be transmitted by nonsexual contact.

• Headache
• Nausea, vomiting
• Stiff neck
• Neck pain
• Stiffness of shoulders, other muscle aches
• Fever
• Sensitivity to light (photophobia)
• Sensitivity to loud noises
• Mental status changes
  • Confusion
  • Disorientation
  • Decreased attention span
  • Irritability
  • Sleepy, lethargic, hard to arouse
• Changes in vision, blurred vision, decreased vision
• Seizures

An examination may indicate meningitis. Focal neurologic deficits (localized loss of nerve functions) may be present. A neurologic examination may show reduced cranial nerve function, including the nerves that control eye movement.

Tests may include:

• EEG (electroencephalogram) if seizures are present.
• Head CT scan.
• Cerebral angiography if vascular symptoms are present.
• Serum VDRL or serum RPR (used as screening tests to detect syphilis infection) -- if positive, requires one the following to confirm diagnosis:
  • FTA-ABS
  • MHA-TP
• CSF (cerebrospinal fluid) examination