[Severe consequences of delayed diagnosis and treatment of neurosyphilis]

A case of full-blown neurosyphilis in a 40 year old university man is demonstrated. The disease was initially misdiagnosed as Creutzfeldt-Jakob disease. Nuclear magnetic resonance scanning supported this diagnosis. One year later the patient was hospitalized owing to increasing neurological deficits. For the first time he was examined for syphilis, and the disease was confirmed by a WR test. Despite lege artis penicillin treatment the patient was left with severe deficits, particularly of the intellect. The old phrase that syphilis can mimic any form of psychopathology is still true, and WR is still the test of choice whenever a neuropsychiatric diagnosis is unclear.