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Case Reports
. 2024 Nov 2;14(6):111-114.
doi: 10.55729/2000-9666.1416. eCollection 2024.

Neuropsychiatric Manifestations of Syphilis

Nadim Ojaimi  1 , Aida Metri  2 , Christopher J Haas  3
Affiliations
Case Reports

Neuropsychiatric Manifestations of Syphilis

Nadim Ojaimi et al. J Community Hosp Intern Med Perspect. .

Abstract

Neurosyphilis is a condition characterized by insidious onset of encephalopathy and delirium. The infrequency with which it is encountered makes neurosyphilis a formidable diagnostic challenge. We present a rare case of a 71-year-old male with ischemic cardiomyopathy, chronic obstructive pulmonary disease (COPD), undifferentiated arthritis and alcohol use disorder who was brought to the emergency department after he was found altered, confused, and paranoid. His hospital stay was eventful for multiple episodes of agitation that were difficult to control despite benzodiazepines and high doses of antipsychotics. After an extensive workup, he was found to have neurosyphilis and his delirium resolved following a brief period of treatment. This case illustrates the importance of early suspicion for neurosyphilis as a cause of delirium, especially in endemic areas and in patients with focal neurologic findings.

Keywords: Delirium; Neurosyphilis; Syphilis.

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Conflict of interest statement

Conflict of interest: The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
FLAIR MR Images showing confluent and scattered foci of increased signaling within bilateral periventricular and subcortical white matter.
Fig. 2
Fig. 2
FLAIR MR Images showing confluent and scattered foci of increased signaling within subcortical white matter.
See this image and copyright information in PMC

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