REVIEW – March 2005

Neurosyphilis in daily practice – can we suspect it?


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The process of urbanisation and the growing number of HIV-infected persons are connected with the increased incidence of syphilis and neurosyphilis. Patients with early forms of syphilis, not diagnosed or properly treated, are at high risk to develop neurosyphilis. The symptoms of neurosyphilis may be neurological or psychiatric, similar to other common diseases as meningitis, TIA, stroke, Alzheimer disease, etc. Syphilitic meningitis, meningovascular syphilis, encephalitis and tabes dorsalis are the main forms of neurosyphilis. In this article we present six cases of neurosyphilis treated from 2001 to 2004 in the North-Estonian Regional Hospital. Only one patient belonged to the social risk group (alcohol and drug abusers), while five patients were ordinary people and the diagnosis of neurosyphilis was not expected. The most frequently diagnosed form of the disease was meningovascular syphilis, which is correlated with literature data.