Traditional Neurosyphilis in 21st Century – Tabes Dorsalis, Dementia Paralytica, Aseptic Meningitis and Unilateral Oculomotor Nerve Palsy in an HIV-Negative Man

Abstract

Syphilis is potentially a multisystem chronic infection caused by Treponema pallidum. Late symptomatic neurosyphilis has been less reported in developed countries, most often seen in untreated patients or in patients with HIV coinfection. We present a case of complicated neurosyphilis with widespread neurological involvement (dementia paralytica, tabes dorsalis, leptomeningitis and left oculomotor nerve involvement) presenting in the 21st century in an urban area of a well-developed European country in an HIV-negative patient.

Neurosyphilis Initially Misdiagnosed as Behavioral Variant Frontotemporal Dementia: Life-Changing Differential Diagnosis

“…What are the key indicators for suspecting neurosyphilis? Recent case reports from the last decade have shown that neurosyphilis tends to progress rapidly, typically within several months to a year [10,[27][28][29][30][31][32][33][34][35], as opposed to degenerative diseases, which develop slowly over several years. This was also observed in the present case, where the patient was in his 40 s, much younger than the age at which degenerative diseases are typically diagnosed.…”

A case of neurosyphilis with psychosis and hippocampal atrophy

“… 1 Neurosyphilis, a complicated bacterial infection of the brain or spinal cord, is uncommon today, unlike during the era before the introduction of penicillin. 2 Only 5%–10% of those infected with syphilis develop this central nervous system comorbidity, and of these, one-third exhibit clinical signs of the disorder. In addition, neurosyphilis may develop during any stage after the initial exposure to syphilis, often manifesting years or even decades later.…”

“…Syphilis, caused by the bacterium Treponema pallidum , is often named ‘the great imitator’ in the literature due to its ability to mimic other conditions 1. Neurosyphilis, a complicated bacterial infection of the brain or spinal cord, is uncommon today, unlike during the era before the introduction of penicillin 2. Only 5%–10% of those infected with syphilis develop this central nervous system comorbidity, and of these, one-third exhibit clinical signs of the disorder.…”