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Misdiagnosed neurosyphilis associated with prolonged psychosis

Published online by Cambridge University Press:  06 June 2016

Justin Faden*
Affiliation:
School of Osteopathic Medicine, Rowan University, Psychiatry, 2250 Chapel Ave, Suite 100, Cherry Hill, NJ, USA
John O’Reardon
Affiliation:
School of Osteopathic Medicine, Rowan University, Psychiatry, 2250 Chapel Ave, Suite 100, Cherry Hill, NJ, USA
*
Justin Faden, School of Osteopathic Medicine, Rowan University, Psychiatry, 2250 Chapel Ave, Suite 100, Cherry Hill, NJ, USA. Tel: 856-482-9000; Fax: 856-482-1159; E-mail: [email protected]

Abstract

Objective

After the prevalence of syphilis had reached historic lows, the Center for Disease Control devised a plan to eradicate syphilis in the United States. Since that decree there has been a dramatic rise in new cases. Psychosis is an ominous symptom of neurosyphilis.

Methods

We report a case of neurosyphilis that was misdiagnosed and staged incorrectly.

Results

Failure to diagnose neurosyphilis was associated with prolonged psychosis that has been refractory to antipsychotic treatment.

Conclusion

Psychiatrists should renew their vigilance for neurosyphilis in the setting of a positive screening test and psychosis.

Type
Case Report
Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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References

1. Sanchez, FM, Zisselman, MH. Treatment of psychiatric symptoms associated with neurosyphilis. Psychosomatics 2007;48:440445.Google Scholar
2. Clement, ME, Okeke, LN, Hicks, CB. Treatment of syphilis: a systematic review. JAMA 2014;312:19051917.CrossRefGoogle ScholarPubMed
3. U.S. Preventive Services Task Force. Screening for syphilis infection: recommendation statement. Ann Fam Med 2004;2:362365.CrossRefGoogle Scholar
4. Saik, S, Kraus, JE, McDonald, A, Mann, SG, Sheitman, BB. Neurosyphilis in newly admitted psychiatric patients: three case reports. J Clin Psychiatry 2004;65:919921.Google Scholar
5. Friedrich, F, Aigner, M, Fearns, N, Friedrich, ME, Frey, R, Geusau, A. Psychosis in neurosyphilis – clinical aspects and implications. Psychopathology 2014;47:39. Epub 2013 May 22.CrossRefGoogle ScholarPubMed
6. Danielsen, A.G., Weismann, K., Jorgensen, B. et al. Incidence, clinical presentation, and treatment of neurosyphilis in Denmark, 1980–1997. Acta Derm Venereol 2004;84:459462.Google Scholar
7. Friedrich, F, Geusau, A, Greisenegger, S, Ossege, M, Aigner, M. Manifest psychosis in neurosyphilis. General Hosp Psychiatry 2009;31:379381.Google Scholar
8. Allen, M, Aisenberg, G, Nix, B, Regenold, WT, Person, C. Psychosis in neurosyphilis: an association of poor prognosis. General Hosp Psychiatry 2014;36:361.e5–6.Google Scholar
9. Moulton, CD, Koychev, I. The effect of penicillin therapy on cognitive outcomes in neurosyphilis: a systematic review of the literature. General Hosp Psychiatry 2015;37:4952.Google Scholar
10. Sivakumar, K, Okocha, CI. Neurosyphilis and schizophrenia. Br J Psychiatry 1992;161:251254.Google Scholar
11. Gatchel, J, Legesse, B, Tayeb, S, Murray, E, Price, B. Neurosyphilis in psychiatric practice: a case-based discussion of clinical evaluation and diagnosis. General Hosp Psychiatry 2015;37:459463.Google Scholar