Pachner A R
Neurol Clin. 1986 Feb;4(1):207-22.
The neurotropism of the spirochete is evident from the above discussions of syphilis, Lyme disease, leptospirosis, and relapsing fever. In all of these diseases, the organism very likely enters the CNS very early in the course of the disease. The fate of the organism then depends on the virulence of the spirochete, the host defenses, and any antibiotic treatment administered. Why Treponema pallidum lays dormant in the CNS and then somehow reactivates is a mystery; the same mystery occurs in Lyme disease. Leptospirosis and relapsing fever seem to be infections much more limited in time, and are not reported to cause these long-term sequelae. The treatment of these last two infections seems to be fairly straightforward. However, the appropriate treatment for the various stages of the disease in both syphilis and Lyme disease in order to prevent long-term sequelae is not universally accepted. At this time, it seems that high-dose intravenous penicillin is the treatment of choice for each of these infections shown to be active in the nervous system.
从上述关于梅毒、莱姆病、钩端螺旋体病和回归热的讨论中可以明显看出螺旋体的嗜神经性。在所有这些疾病中，病原体很可能在疾病过程的早期就进入中枢神经系统。病原体的命运随后取决于螺旋体的毒力、宿主防御机制以及所给予的任何抗生素治疗。梅毒螺旋体为何潜伏在中枢神经系统中然后以某种方式重新激活仍是个谜；莱姆病也存在同样的谜团。钩端螺旋体病和回归热似乎是感染时间更为有限的疾病，未报告有导致这些长期后遗症的情况。后两种感染的治疗似乎相当简单。然而，为预防梅毒和莱姆病的长期后遗症而针对这两种疾病不同阶段的适当治疗方法尚未得到普遍认可。目前，高剂量静脉注射青霉素似乎是这些已证明在神经系统中具有活性的每种感染的首选治疗方法。
