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[Neurosyphilis--still a relevant differential diagnosis]
E Hem1, T Small, S Opjordsmoen
1Avdeling for akuttpsykiatri, Ullevål sykehus, Oslo.
Summary
Neurosyphilis is rare but increasing in neighboring countries. Early diagnosis is crucial, requiring physician awareness and prompt syphilis serology testing for this curable psychiatric disorder.
Area of Science:
- Neurology
- Infectious Diseases
- Psychiatry
Background:
- Syphilis is nearly eradicated in Norway, with low annual case numbers since 1993.
- However, rising syphilis rates in neighboring countries necessitate increased vigilance.
- Neurosyphilis, a serious complication, can present with diverse and challenging symptoms.
Observation:
- Three neurosyphilis cases were diagnosed in an Oslo emergency psychiatric ward between 1994-1997.
- Diagnostic delays of 7 and 15 months occurred in two patients.
- Difficulties include the disease's rarity, mimicry of other conditions, and altered presentations.
Findings:
- Neurosyphilis diagnosis remains challenging due to its varied clinical presentations.
- Partial antibiotic treatment can obscure symptoms, complicating diagnosis.
- Physician awareness and a low threshold for syphilis serology are vital.
Implications:
- Early neurosyphilis diagnosis is critical for effective treatment and patient outcomes.
- Increased physician awareness is essential, especially given regional trends.
- Prompt syphilis testing can lead to early identification of this curable psychiatric disorder.