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Mielopatía sifilítica - Treatment

Nombres alternativos

Ataxia locomotora

Tratamiento:

Los objetivos del tratamiento son curar la infección y reducir el progreso de la afección. El tratamiento de la infección ayuda a prevenir el daño neurológico nuevo y puede disminuir los síntomas, pero no contrarresta el daño existente.

Para la neurosífilis, la opción farmacológica es la penicilina G acuosa (en inyección). Algunos pacientes que sufren de alergia a la penicilina tal vez tengan que someterse a una desensibilización a este fármaco, de tal manera que la puedan utilizar de forma segura para tratar esta enfermedad.

Es necesario hacer un tratamiento de los síntomas para el daño neurológico existente. Las personas que sean incapaces de comer, vestirse o cuidar de sí mismas pueden necesitar ayuda. La rehabilitación, la fisioterapia y la terapia ocupacional pueden ayudar a las personas con debilidad muscular.

Para controlar el dolor, se pueden necesitar analgésicos, los cuales pueden incluir medicamentos que no requieren receta médica, como el ácido acetilsalicílico (aspirin) o paracetamol para el dolor leve, o narcóticos para el dolor más fuerte. Los antiepilépticos, como la carbamazepina, pueden ayudar a tratar los dolores fulgurantes.

Expectativas (pronóstico):

Si la enfermedad no se trata oportunamente se puede presentar discapacidad progresiva.

Complicaciones:

  • Complicaciones de la infección por sífilis en etapa tardía que pueden abarcar:
    • inflamación de la aorta (aortitis) con aneurisma aórtico
    • Valvulopatía
    • daño a huesos, piel y otros órganos
  • Complicaciones de neurosífilis, incluyendo demencia, accidente cerebrovascular, enfermedad ocular
  • Dificultad con la marcha y el equilibrio
  • Parálisis

Situaciones que requieren asistencia médica:

Consulte con el médico si presenta:

  • Reviewed last on: 8/30/2010
  • Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Jatin Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Centers for Disease Control and Prevention (CDC). Recommendations and Reports: Sexually Transmitted Diseases. MMWR Morb Mortal Wkly Rep. 2006;55(RR-11).

U.S. Preventive Services Task Force. Screening for syphilis infection in pregnancy: reaffirmation recommendation statement. Ann Fam Med. 2009;150:705-709.

Screening for Syphilis Infection. Topic Page. July 2004. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockland, MD. Accessed 6/28/2010.

Hook EW III. Syphilis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 340.

Tremont EC. Treponema pallidum (syphilis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2009: chap 238.

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