A Case of Neurosyphilis and Review of Manifestations, Diagnosis, and Treatment.

Diagnosis of neurosyphilis remains a challenge due to no existing standardized testing, but it is often made based on a combination of clinical and cerebrospinal fluid (CSF) analysis findings. Neurosyphilis is uncommon now compared to the era before the introduction of penicillin. Syphilis if left untreated may lead to debilitating complications including paresis, progressive dementia, and even death. Presence of ocular or hearing manifestations with positive serum treponemal and non-treponemal tests are diagnostic for neurosyphilis, regardless of presence or absence of CSF abnormalities. The preferred regimen for neurosyphilis is intravenous penicillin G for 2 weeks. Other regimens are not shown to be as effective as penicillin. Here we discuss an interesting case presenting with neurosyphilis along with manifestations consistent with primary and secondary stages of syphilis.