Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T18:54:10.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Neurosyphilis presenting as psychiatric symptoms: an unusual case report

Published online by Cambridge University Press:  24 June 2014

Hasan Mirsal ,
Ayhan Kalyoncu ,
Özkan Pektaş  and
Mansur Beyazyürek
Hasan Mirsal*
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Ayhan Kalyoncu
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Özkan Pektaş
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Mansur Beyazyürek
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
*
Hasan Mirsal, Balıklı Rum Hastanesi Vakfı, Anatolia Klinikleri, BelgradKapı Yolu No: 2 Zeytinburnu, Istanbul, Turkey. Tel.: +90 212 2492063; Fax: +90 212 2492681; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Neurosyphilis remains a differential diagnosis for a wide variety of psychiatric syndromes, including dementia, mood disorders and psychosis. However, the incidence of neurosyphilis presenting initially with psychiatric symptomalogy is unclear. In this article, a clinical case is reported so as to illustrate some of the issues involved.

Case presentation:

A 33-year-old married man was admitted because of a depressive episode associated with somatic preoccupations and a gradual loss of ability to function a year prior to his admission. The symptoms described above raised the question of an organic brain syndrome associated with the psychotic depression. Some laboratory and additional examinations were performed. Serological tests for syphilis were positive for both the hemagglutination test, Treponema pallidum hemaglutination (TPHA), and the immunofluorescent antibody test, fluorescent treponemal antibody-absorption (FTA-ABS). Based on these findings, the diagnosis of neurosyphilis was made. The patient was treated with benzathine penicillin (2 400 000 units i.m. once a week) for 3 weeks and venlafaxine (150 mg daily) and olanzapine (5 mg daily). His depression disappeared gradually, and he was discharged in partial remission.

Conclusion:

High-risk groups such as patients with neuropsychiatric diseases should be screened with serological tests so as to prevent morbidity and help eliminate syphilis.

Keywords

high-risk groupsneurosyphilispsychiatric symptomstreatment
Type
Case report
Information
Acta Neuropsychiatrica , Volume 19 , Issue 4 , August 2007 , pp. 251 - 253
Copyright
Copyright © 2007 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fallon, BA. Neuropsychiatric aspects of other infectious diseases. In: Sadock, BJ, Sadock, VA, eds. Comprehensive textbook of psychiatry. Philadelphia: Lippincott Williams and Wilkins, 2000, pp 336–345. Google Scholar
Brant, AM. No magic bullet: a social history of venereal disease in the United States since 1980. New York: Oxford University Press, 1987. Google Scholar
Hutto, B. Syphilis in clinical psychiatry: a review. Psychosomatics 2001;42:453–460. CrossRefGoogle ScholarPubMed
Scheck, DN, Hook, E. Neurosyphilis. Infect Dis Clin North Am 1994;8:769–795. Google ScholarPubMed
Hook, HM, Marra, CM. Acquired syphilis in adults. N Engl J Med 1992;326:1060–1069. CrossRefGoogle ScholarPubMed
Güngen, C, Ertan, T, Eker, E, YaŞar, R, Engin, F. Reliability and validity of the Standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish Population. Turk Psikiyatri Derg 2002;4:273–281 (Turkish). Google Scholar
Akdemir, A, ÖRsel, SD, Dağ, İ, Türkçapar, H, Işcan, N, ÖZbay, H. Clinical use and the reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. J Psychiatry Psychol Psychopharmacol 1996;4:251–259. (Turkish). Google Scholar
Overal, JE, Gorham, DR. The brief psychiatric rating scale. Psychol Rep 1962;10:799–812. CrossRefGoogle Scholar
Ali, L, Ross, KL. Antibacterial therapy of neurosyphilis: lack of impact of new therapies. CNS Drugs 2002;16:799–802. CrossRefGoogle ScholarPubMed
Sirota, P, Eviatar, J, Spivak, B. Neurosyphilis presenting as psychiatric disorders. Br J Psychiatry 1989;155:559–561. CrossRefGoogle ScholarPubMed
Roberts, MC, Emsley, RA. Psychiatric manifestations of neurosyphilis. S Afr Med J 1992;82:335–337. Google ScholarPubMed
Klaus, MV, Amarante, L, Beam, TR. Routine screening for syphilis is justified in patients admitted to psychiatric, alcohol and drug rehabilitation wards of the Veterans Administration Medical Center. Arch Dermatol 1989;125:1644–1646. CrossRefGoogle ScholarPubMed