Syphilis still remains a major health concern worldwide because of the possibility of serious medical and psychological consequences, long-term disability, and death. Neurosyphilis (NS) may occur at any stage of infection. Its clinical presentation has been changing over recent years including psychiatric and neurocognitive symptoms. Several recent studies have described cases with these symptoms as the principal signs of NS. We present the case of neurosyphilis with a psychiatric presentation characterized by mood disturbance and auditory and visual hallucinations.
Ropper AH, Samuels MA, Klein JP. Adams and Victor’s principles of neurology. In: Ropper AH, Samuels MA, Klein JP, editors. Infections of the nervous system (bacterial, fungal, spirochetal, parasitic) and sarcoidosis. 10th ed. Boston: McGraw-Hill; 2014. chap. 32; p. 723-8.
LevchikN, PonomarevaM, SurganovaV, ZilberbergN, KungurovN. Criteria for the diagnosis of neurosyphilis in cerebrospinal fluid: relationships with intrathecal immunoglobulin synthesis and blood-cerebrospinal fluid barrier dysfunction. Sex Transm Dis. 2013;40(12):917-22. [https://doi.org/10.1097/OLQ.0000000000000049]. [PMID:24220351]
ZhengD, ZhouD, ZhaoZ, et al. The clinical presentation and imaging manifestation of psychosis and dementia in general paresis: a retrospective study of 116 cases. J Neuropsychiatry Clin Neurosci. 2010;23(3):300-7. [https://doi.org/10.1176/jnp.23.3.jnp300]. [PMID:21948891]
TorresGA, LopesMHI, CheuicheEM, GuilhermanoLG. Profile of patients treated with malariotherapy in a psychiatric hospital in Porto Alegre, Brazil: a historical note. Trends Psychiatry Psychother. 2014;36(3):169-72. [https://doi.org/10.1590/2237-6089-2013-0063].
MarraCM, MaxwellCL, TantaloL, et al. Normalization of cerebrospinal fluid abnormalities after neurosyphilis therapy: does HIV status matter? Clin Infect Dis. 2004;38(7):1001-6. [https://doi.org/10.1086/382532]. [PMID:15034833]