Neurosyphilis mimicking viral encephalitis: report of 4 cases
10.3760/cma.j.cn114798-20200317-00314
- VernacularTitle:类似病毒性脑炎的神经梅毒四例临床分析
- Author:
Bowen ZHENG
1
;
Junhua GAO
;
Dongmei XU
;
Ran MIAO
;
Canglin SONG
;
Wenqing WU
Author Information
1. 首都医科大学附属北京地坛医院神经内科 新发突发传染病研究北京市重点实验室感染病科国家临床重点专科建设项目 100015
- From:
Chinese Journal of General Practitioners
2020;19(9):842-846
- CountryChina
- Language:Chinese
-
Abstract:
The clinical data of 4 patients with atypical neurosyphilis (NS) mimicking viral encephalitis (VE) admitted to Beijing Ditan Hospital from July 2015 to January 2020 were retrospectively analyzed. All the 4 patients were males with an average age of (43±8) years. The patients manifested with mental and behavior disorders and cognitive impairment. Three patients had epilepsy and 1 patient had fever. The treponemal pallidum particle agglutination (TPPA) , fluorescent treponemal antibody-absorption test (FTA-ABS) -IgG and toluidine red unheated serum test (TRUST) were all positive in blood and the cerebral spinal fluid (CSF) , and white blood cell count and protein level in CSF were all evaluated. The head MRIs were all abnormal, 3 of which showed hyperintensity in fluid attenuated inversion recovery (FLAIR) and T2-weighted image located in limbic system and 1 showed hyperintensity in the bilateral cortex and the subcortical areas. All patients improved evidently and the lesions became smaller after penicillin treatment. Atypical NS mimicking VE is rare, and at early diagnosis and timely treatments can contribute to a good clinical prognosis.
