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Neurosyphilis as a cause for neuropsychiatric symptoms: a case report

Published online by Cambridge University Press:  01 September 2022

I. Romero Gerechter  and
M.D.C. Molina Liétor
I. Romero Gerechter*
Affiliation:
Hospital Universitario Príncipe de Asturias, Psiquiatría, Alcalá de Henares, Spain
M.D.C. Molina Liétor
Affiliation:
Hospital Universitario Príncipe de Asturias, Psiquiatría, Alcalá de Henares, Spain
*
*Corresponding author.

Abstract

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Introduction

Syphilis is a sexually transmitted infection which in its late phase can cause all kinds of neuropsychiatric symptoms. A case report of a 79-year-old male with a manic episode probably due to lues is presented.

Objectives

A case of a patient with neurosyphilis is presented followed by a theoretical review on the topic.

Methods

A case is presented with a bibliographic review.

Results

A 79-year-old male was hospitalized with symptoms of disorientation, inattention, and difficulty for abstract thought. His speech was verbose, incoherent with megalomaniac ideas. He presented affective symptoms such as hyperthymia, emotional lability and intermittent crying. He also had nomination problems and recent memory mistakes. He also suffered from insomnia. He presented as his medical history HIV infection under control and syphilis treated in December 2020 with a negative RPR test in June 2021. During his hospitalization he was treated with increasing doses of olanzapine and valproic acid. Irritability improved with this treatment.

Conclusions

Neurosyphilis may be presented as any kind of neuropsychiatric disorder. Laboratory tests are required as there is no conclusive imaging test. Penicillin and symptomatic management are the proper treatment. Neuropsychiatric disorders in elderly population must consider infectious diseases and previous pathologies as differential diagnosis.

Disclosure

No significant relationships.

Keywords

Syphilismanianeuroshyphilisold people psychiatry
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S656
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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