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Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report

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 neurosyp...

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Autores principales: Devanand, Nilesh Anand, Sundararajan, Krishnaswamy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8577006/
https://www.ncbi.nlm.nih.gov/pubmed/34749803
http://dx.doi.org/10.1186/s13256-021-03153-1
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author Devanand, Nilesh Anand
Sundararajan, Krishnaswamy
author_facet Devanand, Nilesh Anand
Sundararajan, Krishnaswamy
author_sort Devanand, Nilesh Anand
collection PubMed
description 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.
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spelling pubmed-85770062021-11-10 Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report Devanand, Nilesh Anand Sundararajan, Krishnaswamy J Med Case Rep Case Report 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. BioMed Central 2021-11-09 /pmc/articles/PMC8577006/ /pubmed/34749803 http://dx.doi.org/10.1186/s13256-021-03153-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Devanand, Nilesh Anand
Sundararajan, Krishnaswamy
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report
title 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_short 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
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8577006/
https://www.ncbi.nlm.nih.gov/pubmed/34749803
http://dx.doi.org/10.1186/s13256-021-03153-1
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