Abstract
We present a 62 year-old male who had a posterior circulation ischemic stroke probably due to meningovascular neurosyphilis, without HIV coinfection. Neurosyphilis can present in a heterogeneous manner. The diagnosis is made with the serologic confirmation, as well as a CSF study. A prompt diagnosis and treatment can prevent neurologic complications.
References
Ghanem KG. REVIEW: Neurosyphilis: A historical perspective and review. CNS Neurosci Ther. 2010;16(5):e157-68.
Clement ME, Okeke NL, Hicks CB. Treatment of syphilis: a systematic review. JAMA. 2014;312(18):1905-17.
Bhai S, Lyons JL. Neurosyphilis Update: Atypical is the New Typical. Curr Infect Dis Rep. 2015;17(5):481.
Chahine LM, Khoriaty RN, Tomford WJ, Hussain MS. The changing face of neurosyphilis. Int J Stroke. 2011;6(2):136-43.
Hook EW III, Marra CM. Acquired syphilis in adults. N Engl J Med. 1992; 16;326(16):1060-9.
Halperin JJ. A tale of two spirochetes: lyme disease and syphilis. Neurol Clin. 2010;28(1):277-91.
Marra CM. Update on neurosyphilis. Curr Infect Dis Rep.2009;11(2):127-34.
Jiménez JA, Ladino L, Uribe CS, et al. Neurosífilis meningovascular con trombosis de la arteria basilar. Biomédica 2012;32(1): 7-12.
Montes MI, Millán P, Uribe CS. Arteritis de Nissl en sífilis meningovascular y falla terapéutica con ceftriaxona. Informe de un caso y revisión en la literatura. MedUNAB 2006; 9(2):174-78.
Ferro JM, Massaro AR, Mas JL. Aetiological diagnosis of isch-aemic stroke in young adults. Lancet Neurol. 2010;9(11):1085-96.
Fugate JE, Lyons JL, Thakur KT, Smith BR, Hedley-Whyte ET, Mateen FJ. Infectious causes of stroke. Lancet Infect Dis. 2014;14(9):869-80.
Wong T, Fonseca K, Chernesky MA, Garceau R, Levett PN, Serhir B. Canadian Public Health Laboratory Network laboratory guidelines for the diagnosis of neurosyphilis in Canada. Can J Infect Dis Med Microbiol. 2015;26(Suppl A):18A-22A.
Harding AS, Ghanem KG. The performance of cerebrospinal fluid treponemal-specific antibody tests in neurosyphilis: a systematic review. Sex Transm Dis. 2012;39(4):291-7.
Wharton M, Chorba TL, Vogt RL, Morse DL, Buehler JW Case definitions for public health surveillance. MMWR Recomm Rep. 1990;39(RR-13):1-43.
Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 20155;64(RR-03):1-137.
Han JH, Lee CC, Crupi RS. Meningovascular syphilis and improvement with tissue-plasminogen activator (T-PA). Am J Emerg Med. 2004;(5):426-7.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
