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Neurosyphilis: A Monkey Among Men.

Cameron Rowe1, Nathan Buckley1, Bhaskar Chhetri1

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Summary
This summary is machine-generated.

Neurosyphilis, a late-stage syphilis infection, can mimic other neurological conditions. Prompt diagnosis and treatment with Penicillin G led to a full recovery in an elderly patient presenting with altered mental status.

Keywords:
FTA-abNeurologyNeurosyphilisPrimary syphilisSecondary syphilisSyphilisTertiary syphilisTreponemaTreponema pallidum

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Neurosyphilis is a serious complication of untreated syphilis caused by *Treponema pallidum*.
  • It can manifest with diverse neurological symptoms, often mimicking other conditions, earning it the nickname 'The Great Pretender'.
  • Early diagnosis and treatment are crucial to prevent severe sequelae.

Observation:

  • An 83-year-old female with a history of TIAs, dementia, and breast cancer presented with altered mental status and ataxia.
  • Initial workup, including brain imaging, was negative for stroke; however, serological tests (RPR and FTA-ab) confirmed neurosyphilis.
  • The patient's symptoms were initially attributed to her pre-existing conditions.

Findings:

  • The patient received intravenous Penicillin G followed by a course of Rocephin.
  • Following treatment, the patient returned to her previous baseline cognitive and functional status.
  • This case highlights the importance of considering neurosyphilis in the differential diagnosis of altered mental status, especially in older adults.

Implications:

  • This case underscores the importance of neurosyphilis screening in patients with unexplained neurological symptoms.
  • Effective treatment can lead to significant improvement, even in elderly patients with comorbidities.
  • Raising awareness among healthcare providers about the varied presentations of neurosyphilis is essential for timely diagnosis and management.