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Acute syphilitic meningitis in a patient with systemic lupus erythematosus
S Lewis1, R Goldman, B Cronstein
1Department of Medicine, New York University Medical Center, NY.
Abstract:
A man with systemic lupus erythematosus receiving chronic steroid therapy presented with headache, fever and panophthalmitis. Cerebrospinal fluid analysis was consistent with syphilitic meningitis. This represents the first reported case of syphilitic meningitis in a lupus patient. Our case report highlights the need to remain alert for unusual manifestations of syphilis in immunosuppressed patients.
Insights
This case report details the first instance of syphilitic meningitis in a patient with systemic lupus erythematosus. It emphasizes the importance of considering syphilis in immunosuppressed individuals presenting with unusual neurological symptoms.
Area of Science:
- Neuroimmunology
- Infectious Diseases
- Rheumatology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Immunosuppressive therapy, including steroids, is common in SLE management.
- Unusual infections can occur in immunocompromised patients.
Observation:
- A patient with SLE on chronic steroid therapy presented with headache, fever, and panophthalmitis.
- Cerebrospinal fluid analysis indicated syphilitic meningitis.
- This is the first reported case of co-occurring syphilitic meningitis and lupus.
Findings:
- The patient's symptoms were attributed to neurosyphilis.
- Cerebrospinal fluid findings confirmed the diagnosis of syphilitic meningitis.
- The presentation highlights a rare complication in an immunosuppressed host.
Implications:
- Clinicians should consider syphilis in immunosuppressed patients with atypical neurological or ophthalmological symptoms.
- Early diagnosis and treatment of syphilis are crucial in this population.
- This case expands the understanding of infectious complications in systemic lupus erythematosus.