We present a case of a patient with tertiary syphilis, manifesting as acute psychosis, auditory hallucinations and intermittent explosive disorder with pending legal ramifications for physical violence. Our patient had been seen and treated by a psychologist with Aripiprazole for his erratic and aggressive behavior coupled with his new found psychosis over a one-year period with no avail. Prior accounts of interaction with the patient described him as "easy going", "laid back", and cooperative.
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