Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-22T10:42:53.512Z Has data issue: false hasContentIssue false
  • English
  • Français

A late form of neurosyphilis manifesting with psychotic symptoms in old age and good response to ceftriaxone therapy

Published online by Cambridge University Press:  15 September 2010

Erdem Güler  and
Thomas Leyhe
Erdem Güler
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
Thomas Leyhe*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
*
Correspondence should be addressed to: PD Dr. Thomas Leyhe, University of Tübingen, Department of Psychiatry and Psychotherapy, Osianderstraße 24, 72076 Tübingen, Germany. Phone: +49 07071 2982311; Fax: +49 07071 294141. Email: [email protected].
Get access

Abstract

Neurosyphilis can present with psychiatric symptoms. The late form can occur in old age with psychosis, paranoid delusions, affective disorders or cognitive impairment. Here we present a case of neurosyphilis in an elderly woman who, over six months, progressively manifested personality changes and paranoid delusions which were initially suspected as Alzheimer's disease. Psychotic symptoms showed a good response to antibiotic treatment. We conclude that neurosyphilis is a relevant differential diagnosis in patients developing severe psychiatric symptoms in old age. As a causal antibiotic treatment is possible this infectious disease should be considered seriously in gerontopsychiatric patients.

Keywords

neurosyphilispsychosisAlzheimer's diseasedifferential diagnosisantibiotic treatmentold age
Type
Case Report
Information
International Psychogeriatrics , Volume 23 , Issue 4 , May 2011 , pp. 666 - 669
Copyright
Copyright © International Psychogeriatric Association 2010

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

Broadway, J. and Mintzer, J. (2007). The many faces of psychosis in the elderly. Current Opinion in Psychiatry, 20, 551–558.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (2006). Sexually transmitted disease treatment guidelines. Mortality and Morbidity Weekly Report, 55, 40–43.Google Scholar
Conde-Sendín, M. A., Hernández-Fleta, J. L., Cárdenes-Santana, M. A. and Amela-Peris, R. (2002). Neurosyphilis: forms of presentation and clinical management. Revista de Neurologia, 35, 380–386.Google ScholarPubMed
Felman, Y. M. and Nikitas, J. A. (1980). Syphilis serology today. Archives of Dermatology, 116, 84–89.CrossRefGoogle ScholarPubMed
German Society for Neurology (2008). Guidelines for Diagnostics and Therapy in Neurology. Stuttgart: Georg Thieme Verlag.Google Scholar
Miklossy, J. (2008). Chronic inflammation and amyloidogenesis in Alzheimer's disease: role of spirochetes. Journal of Alzheimer's Disease, 13, 381–391.CrossRefGoogle ScholarPubMed
Mitchell, A. J. (2009). CSF phosphorylated tau in the diagnosis and prognosis of mild cognitive impairment and Alzheimer's disease: a meta-analysis of 51 studies. Journal of Neurology, Neurosurgery and Psychiatry, 80, 966–975.CrossRefGoogle ScholarPubMed
Paraskevas, G. P., Kapaki, E., Kararizou, E., Mitsonis, C., Sfagos, C. and Vassilopoulos, D. (2007). Cerebrospinal fluid tau protein is increased in neurosyphilis: a discrimination from syphilis without nervous system involvement? Sexually Transmitted Disease, 34, 220–223.CrossRefGoogle ScholarPubMed
Prange, H. and Matschke, M. (2007). Neurosyphylis. In Brandt, T., Dichgans, J. and Diener, H. J. (eds.), Therapie und Verlauf neurologischer Erkrankungen (pp. 565–570). Stuttgart: Kohlhammer Verlag.Google Scholar
Roberts, M. C. and Emsley, R. A. (1992). Psychiatric manifestations of neurosyphilis. South African Medical Journal, 82, 335–337.Google ScholarPubMed
Russouw, H. G., Roberts, M. C., Emsley, R. A. and Joubert, J. J. (1994). The usefulness of cerebrospinal fluid tests for neurosyphilis. South African Medical Journal, 84, 682–684.Google ScholarPubMed