{"id":58126,"date":"2026-03-12T16:36:38","date_gmt":"2026-03-12T16:36:38","guid":{"rendered":"https:\/\/www.mediconanet.pt\/?p=58126"},"modified":"2026-03-16T09:27:42","modified_gmt":"2026-03-16T09:27:42","slug":"neurossifilis-sifilis-ocular-diagnostico","status":"publish","type":"post","link":"https:\/\/www.mediconanet.pt\/en\/neurossifilis-sifilis-ocular-diagnostico\/","title":{"rendered":"Neuross\u00edfilis e S\u00edfilis Ocular: Complica\u00e7\u00f5es Neurol\u00f3gicas da S\u00edfilis"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"58126\" class=\"elementor elementor-58126\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-570cfe3 e-flex e-con-boxed e-con e-parent\" data-id=\"570cfe3\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1761780 elementor-widget elementor-widget-text-editor\" data-id=\"1761780\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2><b>Introdu\u00e7\u00e3o<\/b><\/h2><p><span style=\"font-weight: 400;\">A <strong>neuross\u00edfilis<\/strong> e a s\u00edfilis ocular s\u00e3o complica\u00e7\u00f5es graves da infe\u00e7\u00e3o por Treponema pallidum que podem ocorrer em qualquer fase da doen\u00e7a, incluindo nos estadios precoces. O ressurgimento da s\u00edfilis na Europa levou a um aumento concomitante dos casos de neuross\u00edfilis e s\u00edfilis ocular, representando um desafio diagn\u00f3stico para cl\u00ednicos de diversas especialidades.<\/span><\/p><p><span style=\"font-weight: 400;\">O Centers for Disease Control and Prevention (CDC) emitiu um alerta em 2023 sobre o aumento de casos de s\u00edfilis ocular nos Estados Unidos, e a European Centre for Disease Prevention and Control (ECDC) reportou tend\u00eancias semelhantes na Europa. O reconhecimento precoce destas manifesta\u00e7\u00f5es e o tratamento adequado s\u00e3o essenciais para prevenir sequelas neurol\u00f3gicas e visuais irrevers\u00edveis.<\/span><\/p><h2><b>Neuross\u00edfilis: Apresenta\u00e7\u00e3o e Tipos<\/b><\/h2><p><span style=\"font-weight: 400;\">A <strong>neuross\u00edfilis<\/strong> ocorre quando o Treponema pallidum invade o sistema nervoso central (SNC), o que pode acontecer semanas a d\u00e9cadas ap\u00f3s a infe\u00e7\u00e3o prim\u00e1ria. As formas precoces incluem meningite sifil\u00edtica (cefaleias, rigidez de nuca, paralisia de nervos cranianos) e s\u00edfilis meningovascular (AVC em adulto jovem).<\/span><\/p><p><span style=\"font-weight: 400;\">As formas tardias de <strong>neuross\u00edfilis<\/strong> incluem a paresia geral (dem\u00eancia progressiva, altera\u00e7\u00f5es de personalidade e comportamento) e o tabes dorsalis (ataxia, dores lancinantes, perda de reflexos e disfun\u00e7\u00e3o auton\u00f3mica). A British Association for Sexual Health and HIV (BASHH) refor\u00e7a que estas apresenta\u00e7\u00f5es tardias s\u00e3o raras na era antibi\u00f3tica, mas ainda ocorrem em doentes n\u00e3o diagnosticados.<\/span><\/p><p><span style=\"font-weight: 400;\">Em pessoas com coinfec\u00e7\u00e3o VIH\/s\u00edfilis, a <strong>neuross\u00edfilis<\/strong> pode ocorrer mais precocemente e com apresenta\u00e7\u00f5es at\u00edpicas. A European AIDS Clinical Society (EACS) recomenda avalia\u00e7\u00e3o de <strong>neuross\u00edfilis<\/strong> em todos os doentes VIH-positivos com s\u00edfilis e contagem de CD4 inferior a 350 c\u00e9lulas\/\u03bcL.<\/span><\/p><h2><b>S\u00edfilis Ocular e Otoss\u00edfilis<\/b><\/h2><p><span style=\"font-weight: 400;\">A s\u00edfilis ocular pode afetar qualquer estrutura do olho, manifestando-se como uve\u00edte (anterior, posterior ou panuve\u00edte), neurite \u00f3ptica, retinite ou queratite intersticial. A apresenta\u00e7\u00e3o mais comum \u00e9 a uve\u00edte posterior, com diminui\u00e7\u00e3o da acuidade visual, floaters e fotofobia.<\/span><\/p><p><span style=\"font-weight: 400;\">A otoss\u00edfilis manifesta-se por perda auditiva neurossensorial, zumbidos e vertigens, podendo ser uni ou bilateral. Tanto a s\u00edfilis ocular como a otoss\u00edfilis s\u00e3o tratadas como <strong>neuross\u00edfilis<\/strong>, independentemente dos achados no l\u00edquido cefalorraquidiano.<\/span><\/p><p><span style=\"font-weight: 400;\">A International Union against Sexually Transmitted Infections (IUSTI) alerta que a s\u00edfilis ocular pode ser a primeira manifesta\u00e7\u00e3o da infe\u00e7\u00e3o sifil\u00edtica, antes mesmo do diagn\u00f3stico serol\u00f3gico de s\u00edfilis. Oftalmologistas e otorrinolaringologistas devem manter elevado \u00edndice de suspei\u00e7\u00e3o para s\u00edfilis em casos de uve\u00edte ou surdez s\u00fabita inexplicadas.<\/span><\/p><h2><b>Diagn\u00f3stico e Tratamento<\/b><\/h2><p><span style=\"font-weight: 400;\">O diagn\u00f3stico de <strong>neuross\u00edfilis<\/strong> requer pun\u00e7\u00e3o lombar com an\u00e1lise do l\u00edquido cefalorraquidiano (LCR): pleocitose linfoc\u00edtica, proteinorraquia elevada e VDRL reativo no LCR s\u00e3o crit\u00e9rios diagn\u00f3sticos. O VDRL no LCR \u00e9 espec\u00edfico mas pouco sens\u00edvel (30 a 70 %).<\/span><\/p><p><span style=\"font-weight: 400;\">O teste FTA-ABS no LCR tem elevada sensibilidade mas baixa especificidade. A combina\u00e7\u00e3o de achados cl\u00ednicos, serologia s\u00e9rica e an\u00e1lise do LCR \u00e9 necess\u00e1ria para o diagn\u00f3stico definitivo. O CDC recomenda pun\u00e7\u00e3o lombar em doentes com s\u00edfilis e sintomas neurol\u00f3gicos, oftalmol\u00f3gicos ou auditivos.<\/span><\/p><p><span style=\"font-weight: 400;\">O tratamento da<\/span><a href=\"https:\/\/www.mediconanet.pt\/sintomas-da-sifilis-fases-da-doenca\/\" target=\"_blank\" rel=\"noopener\"> neuross\u00edfilis\u00a0<\/a><span style=\"font-weight: 400;\">e s\u00edfilis ocular \u00e9 a penicilina G cristalina aquosa 18 a 24 milh\u00f5es UI\/dia por via intravenosa durante 10 a 14 dias. A monitoriza\u00e7\u00e3o com pun\u00e7\u00e3o lombar de controlo aos 6 meses avalia a resposta ao tratamento, com normaliza\u00e7\u00e3o progressiva dos par\u00e2metros do LCR.<\/span><\/p><p><i><span style=\"font-weight: 400;\">Na <\/span><b>M\u00e9dico na Net<\/b><span style=\"font-weight: 400;\">, a <strong>equipa cl\u00ednica<\/strong> oferece avalia\u00e7\u00e3o especializada de complica\u00e7\u00f5es neurol\u00f3gicas e oftalmol\u00f3gicas da s\u00edfilis, com diagn\u00f3stico completo e referencia\u00e7\u00e3o para tratamento adequado.<\/span><\/i><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-375973d elementor-widget elementor-widget-image\" data-id=\"375973d\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/03\/wpimage-id893sizeSlugfulllinkDestinationnone-figure-classwp-block-image-size-fullimg-srchttpscomprarcbdonline.ptwp-contentuploads202603unnamed-3.jpg-altFrasco-de-vidro-transparente-c-13.jpg\" title=\"Consulta m\u00e9dica online para diagn\u00f3stico e acompanhamento da neuross\u00edfilis\" alt=\"Mulher em consulta m\u00e9dica por videochamada com m\u00e9dico no computador durante avalia\u00e7\u00e3o cl\u00ednica de neuross\u00edfilis\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1545e08 e-flex e-con-boxed e-con e-parent\" data-id=\"1545e08\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9ad30cf e-con-full e-flex e-con e-child\" data-id=\"9ad30cf\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-66e4f21 e-con-full e-flex e-con e-child\" data-id=\"66e4f21\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c44ae3e elementor-widget elementor-widget-heading\" data-id=\"c44ae3e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Perguntas frequentes (FAQ)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-439b5c3 elementor-widget elementor-widget-n-accordion\" data-id=\"439b5c3\" data-element_type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7080\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7080\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> A s\u00edfilis pode afetar a vis\u00e3o? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7080\" class=\"elementor-element elementor-element-d801294 e-con-full e-flex e-con e-child\" data-id=\"d801294\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7080\" class=\"elementor-element elementor-element-67dd609 e-flex e-con-boxed e-con e-child\" data-id=\"67dd609\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2204be5 elementor-widget elementor-widget-text-editor\" data-id=\"2204be5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Sim. A s\u00edfilis ocular pode causar uve\u00edte, neurite \u00f3ptica e outras les\u00f5es oculares que, sem tratamento, podem levar a perda visual permanente. O tratamento precoce preserva a fun\u00e7\u00e3o visual.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7081\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7081\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> A neuross\u00edfilis \u00e9 frequente? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7081\" class=\"elementor-element elementor-element-f07e3ff e-con-full e-flex e-con e-child\" data-id=\"f07e3ff\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7081\" class=\"elementor-element elementor-element-ba0d7df e-flex e-con-boxed e-con e-child\" data-id=\"ba0d7df\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bd0918d elementor-widget elementor-widget-text-editor\" data-id=\"bd0918d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">A <strong>neuross\u00edfilis<\/strong> \u00e9 relativamente rara na popula\u00e7\u00e3o geral tratada, mas o risco aumenta em doentes n\u00e3o diagnosticados e em coinfetados com VIH. O ressurgimento da s\u00edfilis est\u00e1 a aumentar a incid\u00eancia de neuross\u00edfilis.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7082\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7082\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Como se diagnostica a neuross\u00edfilis? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7082\" class=\"elementor-element elementor-element-1948aa2 e-con-full e-flex e-con e-child\" data-id=\"1948aa2\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7082\" class=\"elementor-element elementor-element-44203e4 e-flex e-con-boxed e-con e-child\" data-id=\"44203e4\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-90363e4 elementor-widget elementor-widget-text-editor\" data-id=\"90363e4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">O diagn\u00f3stico requer pun\u00e7\u00e3o lombar com an\u00e1lise do l\u00edquido cefalorraquidiano, incluindo VDRL no LCR. A combina\u00e7\u00e3o de achados cl\u00ednicos e laboratoriais \u00e9 necess\u00e1ria para confirma\u00e7\u00e3o.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7083\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7083\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> O tratamento da neuross\u00edfilis \u00e9 diferente? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7083\" class=\"elementor-element elementor-element-e6b82d0 e-con-full e-flex e-con e-child\" data-id=\"e6b82d0\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7083\" class=\"elementor-element elementor-element-ff98332 e-flex e-con-boxed e-con e-child\" data-id=\"ff98332\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b745fb3 elementor-widget elementor-widget-text-editor\" data-id=\"b745fb3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Sim. A <strong>neuross\u00edfilis<\/strong> requer penicilina intravenosa durante 10 a 14 dias, ao contr\u00e1rio da s\u00edfilis precoce que \u00e9 tratada com penicilina intramuscular em dose \u00fanica. A hospitaliza\u00e7\u00e3o pode ser necess\u00e1ria.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7084\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7084\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> A s\u00edfilis pode causar surdez? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7084\" class=\"elementor-element elementor-element-7547615 e-con-full e-flex e-con e-child\" data-id=\"7547615\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7084\" class=\"elementor-element elementor-element-8c9a957 e-flex e-con-boxed e-con e-child\" data-id=\"8c9a957\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2f07efa elementor-widget elementor-widget-text-editor\" data-id=\"2f07efa\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Sim. A otoss\u00edfilis pode causar perda auditiva neurossensorial, que pode ser permanente se n\u00e3o tratada atempadamente. A surdez s\u00fabita inexplicada em adultos jovens deve motivar rastreio de s\u00edfilis.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"A s\\u00edfilis pode afetar a vis\\u00e3o?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sim. A s\\u00edfilis ocular pode causar uve\\u00edte, neurite \\u00f3ptica e outras les\\u00f5es oculares que, sem tratamento, podem levar a perda visual permanente. O tratamento precoce preserva a fun\\u00e7\\u00e3o visual.\"}},{\"@type\":\"Question\",\"name\":\"A neuross\\u00edfilis \\u00e9 frequente?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"A neuross\\u00edfilis \\u00e9 relativamente rara na popula\\u00e7\\u00e3o geral tratada, mas o risco aumenta em doentes n\\u00e3o diagnosticados e em coinfetados com VIH. O ressurgimento da s\\u00edfilis est\\u00e1 a aumentar a incid\\u00eancia de neuross\\u00edfilis.\"}},{\"@type\":\"Question\",\"name\":\"Como se diagnostica a neuross\\u00edfilis?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"O diagn\\u00f3stico requer pun\\u00e7\\u00e3o lombar com an\\u00e1lise do l\\u00edquido cefalorraquidiano, incluindo VDRL no LCR. A combina\\u00e7\\u00e3o de achados cl\\u00ednicos e laboratoriais \\u00e9 necess\\u00e1ria para confirma\\u00e7\\u00e3o.\"}},{\"@type\":\"Question\",\"name\":\"O tratamento da neuross\\u00edfilis \\u00e9 diferente?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sim. A neuross\\u00edfilis requer penicilina intravenosa durante 10 a 14 dias, ao contr\\u00e1rio da s\\u00edfilis precoce que \\u00e9 tratada com penicilina intramuscular em dose \\u00fanica. A hospitaliza\\u00e7\\u00e3o pode ser necess\\u00e1ria.\"}},{\"@type\":\"Question\",\"name\":\"A s\\u00edfilis pode causar surdez?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sim. A otoss\\u00edfilis pode causar perda auditiva neurossensorial, que pode ser permanente se n\\u00e3o tratada atempadamente. A surdez s\\u00fabita inexplicada em adultos jovens deve motivar rastreio de s\\u00edfilis.\"}}]}<\/script>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-02d7fba e-flex e-con-boxed e-con e-parent\" data-id=\"02d7fba\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ca91313 elementor-widget elementor-widget-text-editor\" data-id=\"ca91313\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2><b>Conclus\u00e3o<\/b><\/h2>\n<span style=\"font-weight: 400;\">A <strong>neuross\u00edfilis<\/strong> e a s\u00edfilis ocular s\u00e3o complica\u00e7\u00f5es graves que podem ocorrer em qualquer fase da s\u00edfilis, exigindo elevado \u00edndice de suspei\u00e7\u00e3o cl\u00ednica. O diagn\u00f3stico com an\u00e1lise do LCR, o tratamento com penicilina intravenosa e a monitoriza\u00e7\u00e3o da resposta terap\u00eautica s\u00e3o fundamentais para prevenir sequelas neurol\u00f3gicas e sensoriais irrevers\u00edveis.<\/span>\n<h2><b>Refer\u00eancias<\/b><\/h2>\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37499999\/\" rel=\"dofollow noopener\" target=\"_blank\">Neurosyphilis \u2014 Continuum: Lifelong Learning in Neurology (Neuroinfectious Disease)<\/a>\n\n<a href=\"https:\/\/www.cdc.gov\/std\/syphilis\/clinical-advisory-ocular-syphilis.htm\" rel=\"dofollow noopener\" target=\"_blank\">Clinical Advisory: Ocular Syphilis in the United States \u2014 Centers for Disease Control and Prevention (CDC)<\/a>\n\n<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.16946\" rel=\"dofollow noopener\" target=\"_blank\">2020 European guideline on the management of syphilis \u2014 IUSTI \/ WHO Europe (Journal of the European Academy of Dermatology and Venereology)<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Introdu\u00e7\u00e3o A neuross\u00edfilis e a s\u00edfilis ocular s\u00e3o complica\u00e7\u00f5es graves da infe\u00e7\u00e3o por Treponema pallidum que podem ocorrer em qualquer fase da doen\u00e7a, incluindo nos estadios precoces. O ressurgimento da s\u00edfilis na Europa levou a um aumento concomitante dos casos de neuross\u00edfilis e s\u00edfilis ocular, representando um desafio diagn\u00f3stico para cl\u00ednicos de diversas especialidades. O [&hellip;]<\/p>\n","protected":false},"author":13102,"featured_media":58237,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[59],"tags":[],"class_list":["post-58126","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saude-sexual"],"jetpack_featured_media_url":"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/03\/wpimage-id893sizeSlugfulllinkDestinationnone-figure-classwp-block-image-size-fullimg-srchttpscomprarcbdonline.ptwp-contentuploads202603unnamed-3.jpg-altFrasco-de-vidro-transparente-c-23.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/58126","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/users\/13102"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/comments?post=58126"}],"version-history":[{"count":7,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/58126\/revisions"}],"predecessor-version":[{"id":58136,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/58126\/revisions\/58136"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/media\/58237"}],"wp:attachment":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/media?parent=58126"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/categories?post=58126"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/tags?post=58126"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}