Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report
Abstract Introduction Neurosyphilis is an infection caused by the spirochete Treponema pallidum, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as...
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oai:doaj.org-article:1900367793464bb390960628ce2a36d92021-11-14T12:37:49ZGummatous neurosyphilis in an elderly patient in the Australian outback: a case report10.1186/s13256-021-03153-11752-1947https://doaj.org/article/1900367793464bb390960628ce2a36d92021-11-01T00:00:00Zhttps://doi.org/10.1186/s13256-021-03153-1https://doaj.org/toc/1752-1947Abstract Introduction Neurosyphilis is an infection caused by the spirochete Treponema pallidum, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as neurosyphilis masquerades with various clinical symptoms and is often missed during initial presentation to the hospital. A comprehensive history and clinical examination are essential to detect suspicious cases early for further cerebrospinal fluid examination and neuroimaging. Patients treated with benzylpenicillin for a specific duration often show promising clinical and cognitive improvement, thus emphasizing the need for constant vigilance in our day-to-day practice. Case presentation A 77-year-old Caucasian gentleman presented to our hospital repeatedly with multiple episodes of presyncope and cognitive impairment. He also demonstrated bilateral deafness, tabes dorsalis, and left sixth cranial nerve palsy. His cerebrospinal fluid examination showed a nonreactive venereal disease research laboratory test, and magnetic resonance imaging of the brain revealed a gumma. Conclusion The diagnosis of neurosyphilis in the elderly requires a combination of clinical vigilance and a high index of suspicion, along with multimodal investigations, including cerebrospinal fluid examination and brain imaging.Nilesh Anand DevanandKrishnaswamy SundararajanBMCarticleSyphilisNeurosyphilisGummaCSF VDRLMedicineRENJournal of Medical Case Reports, Vol 15, Iss 1, Pp 1-4 (2021) |
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Syphilis Neurosyphilis Gumma CSF VDRL Medicine R |
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Syphilis Neurosyphilis Gumma CSF VDRL Medicine R Nilesh Anand Devanand Krishnaswamy Sundararajan Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report |
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Abstract Introduction Neurosyphilis is an infection caused by the spirochete Treponema pallidum, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as neurosyphilis masquerades with various clinical symptoms and is often missed during initial presentation to the hospital. A comprehensive history and clinical examination are essential to detect suspicious cases early for further cerebrospinal fluid examination and neuroimaging. Patients treated with benzylpenicillin for a specific duration often show promising clinical and cognitive improvement, thus emphasizing the need for constant vigilance in our day-to-day practice. Case presentation A 77-year-old Caucasian gentleman presented to our hospital repeatedly with multiple episodes of presyncope and cognitive impairment. He also demonstrated bilateral deafness, tabes dorsalis, and left sixth cranial nerve palsy. His cerebrospinal fluid examination showed a nonreactive venereal disease research laboratory test, and magnetic resonance imaging of the brain revealed a gumma. Conclusion The diagnosis of neurosyphilis in the elderly requires a combination of clinical vigilance and a high index of suspicion, along with multimodal investigations, including cerebrospinal fluid examination and brain imaging. |
format |
article |
author |
Nilesh Anand Devanand Krishnaswamy Sundararajan |
author_facet |
Nilesh Anand Devanand Krishnaswamy Sundararajan |
author_sort |
Nilesh Anand Devanand |
title |
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report |
title_short |
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report |
title_full |
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report |
title_fullStr |
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report |
title_full_unstemmed |
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report |
title_sort |
gummatous neurosyphilis in an elderly patient in the australian outback: a case report |
publisher |
BMC |
publishDate |
2021 |
url |
https://doaj.org/article/1900367793464bb390960628ce2a36d9 |
work_keys_str_mv |
AT nileshananddevanand gummatousneurosyphilisinanelderlypatientintheaustralianoutbackacasereport AT krishnaswamysundararajan gummatousneurosyphilisinanelderlypatientintheaustralianoutbackacasereport |
_version_ |
1718429092504666112 |