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Neurosyphilis Presenting With Subtle Clinical Features: A Diagnostic and Therapeutic Challenge
Tejash Shahi1, Deepti Barakoti1, Saurav Ghimire1
1Department of Medicine, Provincial Hospital Bhadrapur, Jhapa Koshi Province, Nepal.
Case Reports in Neurological Medicine
|April 17, 2026
Summary
This case study highlights a neurosyphilis diagnosis in a male patient presenting with neurological symptoms. Early detection and treatment with antibiotics are crucial for preventing lasting neurological damage from this syphilis manifestation.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Syphilis is a global health concern with increasing incidence.
- Neurosyphilis, a central nervous system manifestation of syphilis, presents diagnostic challenges due to nonspecific symptoms.
- Timely diagnosis and treatment are vital to prevent irreversible neurological damage.
Purpose of the Study:
- To report a case of neurosyphilis in a young male.
- To emphasize the importance of considering neurosyphilis in patients with relevant risk factors and symptoms.
- To highlight the effectiveness of prompt antibiotic treatment.
Main Methods:
- Case report of a 36-year-old male with acute neurological symptoms.
- Diagnostic workup included VDRL and TPHA tests on blood and cerebrospinal fluid.
- Treatment administered using ceftriaxone and doxycycline.
Main Results:
- VDRL and TPHA tests were reactive in both blood and cerebrospinal fluid, confirming neurosyphilis.
- The patient showed successful treatment outcomes following antibiotic therapy.
- The case underscores the diagnostic difficulties and clinical presentation of neurosyphilis.
Conclusions:
- Neurosyphilis requires a high index of suspicion, especially in individuals with risk factors.
- Early diagnosis and appropriate antibiotic treatment are essential for favorable outcomes.
- This case emphasizes the need for increased awareness and prompt management of neurosyphilis.
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