Neurosyphilis complicated with pial arteriovenous fistula

Abstract

Introduction:Neurosyphilis is a chronic, infectious disease of the central nervous system. Pial arteriovenous fistulae (PAVF) are rare vascular malformations. Both can cause vascular damage, but it is quite rare for both to present at the same time.Patient concerns:Here we present a 66-year-old man with affective disorder, hypomnesia, and recent convulsions. Magnetic resonance imaging revealed cerebral swelling, hyperintensity in the cortex/subcortex, and multiple lacunar cerebral infarctions. Computed tomography angiography revealed the presence of a pial arteriovenous fistula.Diagnoses:Based on laboratory tests and imaging, diagnoses of neurosyphilis and pial arteriovenous fistula were made.Interventions:Antisyphilis therapy was provided.Outcomes:Symptoms improved and antisyphilis treatment continued as an outpatient. No intracranial hemorrhage was seen 6 months later.Conclusion:Treponema pallidum infection may be related to the formation of PAVF, and may also promote the progression of it; however, further work is required to confirm this.

Cerebrospinal Fluid Changes and Clinical Features of Neurosyphilis Compared with Latent Syphilis Infection in the Central Nervous System: A Cross-Sectional Study

“…Neurosyphilis is a chronic central nervous system disease that can cause nervous tissue and vascular diseases. [9][10][11] It may occur 5-10 years after the initial infection. About 13.5-30% of untreated syphilis patients eventually develop neurosyphilis.…”

Gastrointestinal bleeding caused by syphilis: A case report

“…There are also many reports of patients with cardiovascular syphilis needing mitral valve and tricuspid valve surgery[ 9 - 11 ]. In recent years, some rare cases of syphilis infection with formation of colorectal inflammatory masses that caused gastrointestinal bleeding[ 2 ], and cranial nerve infection that caused neurological disease[ 12 ] have been reported. There have been cases associated with hepatitis, sclerosing cholangitis, pancreatitis, unilateral nipple bleeding, papillary edema, venous congestion, obstruction, intracranial hemorrhage, cerebral infarction, and other systemic diseases[ 13 - 17 ].…”