Meningovascular neurosyphilis: a report of stroke in a young adult

Antanas Vaitkus,Eglė Krasauskaitė,Inga Urbonavičiūtė

doi:10.3390/medicina46040039

Abstract

A young adult patient with meningovascular neurosyphilis in the form of acute ischemic stroke with right hemiparesis and speech disturbance is reported. CT scan showed features of ischemic infarct and extensive laboratory studies were made before the diagnosis ultimately was revealed. Such cases could result in confusion for the clinician, and high index of clinical suspicion of this condition is required since syphilis is not routinely tested, as routine screening is seen to be of low diagnostic yield. As clinical practice indicates, it remains a difficult problem approaching diagnosis of neurosyphilis, and this is achieved through exclusion of neurosyphilis as a clinical possibility.

Highlights

Syphilis is a chronic multisystem infection caused by a thin, spiral, motile organism, Treponema pallidum spp. pallidum
It is certainly true that neurosyphilis nowadays is a rare disorder in the developed world except in the context of human immunodeficiency virus infection and, may be overlooked as its prevalence has been drastically reduced with the advent of penicillin therapy [3,4,5]
It has been suggested that HIV-infected individuals are more likely to develop clinical neurosyphilis and this happens after shorter latent period compared to non-HIV-infected ones [1, 8]

Summary

Introduction

Syphilis is a chronic multisystem infection caused by a thin, spiral, motile organism, Treponema pallidum spp. pallidum. It is certainly true that neurosyphilis nowadays is a rare disorder in the developed world except in the context of human immunodeficiency virus infection and, may be overlooked as its prevalence has been drastically reduced with the advent of penicillin therapy [3,4,5]. It is still a common illness in developing countries [4, 6]. Neurosyphilis can manifest as a stroke-like syndrome [10], intracranial space-occupying lesion [11], dementia [12] and psychosis, or as movement disorders and can mimic amyotrophic lateral sclerosis, spinal cord compression, or transverse myelitis [13]

Findings

Discussion

Conclusion