A Case of Neurosyphilis Presenting as a Stroke in a Patient with Human Immunodeficiency Virus Infection / 대한내과학회지

ABSTRACT

While the neurologic manifestations of syphilis are diverse, stroke is a rare initial manifestation. We report a human immunodeficiency virus (HIV)-positive patient whose neurosyphilis presented as a stroke. A 42-year-old male visited the emergency room due to decreased mental functioning. Brain magnetic resonance imaging showed acute infarct on the left frontal, temporal, and parietal lobes. A serum Venereal Disease Research Laboratory (VDRL) test was positive. ELISA for HIV antibody and Western blot assays revealed he was infected with HIV. The cerebrospinal fluid (CSF) VDRL test was positive and protein was increased. The patient was treated with heparization and penicillin G for 14 days. His mental status improved with treatment, and CSF protein and VDRL titers were also decreased 3 months after treatment.