Neurosyphilis (Ocular Syphilis) with Bilateral Temporal Lobe Atrophy in an HIV patient: A case report
- Author:
Vaughn Caesar L. Edulan
1
;
Jeremyjones Robles
1
;
Carmela Remotigue
1
Author Information
- Publication Type:Journal Article
- Keywords: Ocular syphilis; Cerebral brain atrophy
- MeSH: Syphilis; Neurosyphilis
- From: Philippine Journal of Internal Medicine 2017;55(4):1-4
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Before the advent of antibiotics, syphilis was
known to be one of the most common infections affecting
approximately 10% of the adult population worldwide. One
of its devastating complications is neurosyphilis, which has
a broad set of manifestations. Some patients may present
with blurring of vision in the setting of an ongoing syphilis
infection known as ocular syphilis. In the advent of increasing
incidence of human immunodeficiency virus (HIV) infection,
co-infection with it may further obscure its manifestations or
may even cause synergistic effects.
Case Presentation:Presenting a case of a 26-year-old male patient who complained of bilateral fronto-occipital headache with progressive blurring of vision and scaly reddish to brown maculopapular lesions affecting the limbs prominently the soles and palms. CT scan showed cerebral atrophy prominently on the temporal lobe bilaterally. Mental status exam was normal. Neurosyphilis was confirmed by CSF studies and patient tested positive for HIV infection. Patient was then started on aqueous crystalline benzathine penicillin G four million units every four hours for ten days and was discharged with improved condition and no neurocognitive deficits. . He was advised to have CD4 count and other work up for his HIV infection as outpatient.
Conclusion:The reported incidence of neurosyphilis is increasing in the advent of HIV infection. The deficiency of a clear epidemiology, pathophysiology and complications of cerebral atrophy in neurosyphilis patients co-infected with HIV necessitates further studies to elucidate the proper approach to this preventable and treatable disease. - Full text:PJIM 46.pdf
