[Neurosyphilis or not - a case of a differential diagnostic challenge]

Ideggyogy Sz. 2023 Sep 30;76(9-10):356-360. doi: 10.18071/isz.76.0356.
[Article in Hungarian]

Abstract

<p>We report the case of a 42-year-old woman with paraparesis associated with transverse myelitis. For differential diagnostics detailed microbiological, cerebrospinal fluid (CSF) and neuroimaging examinations were performed. Syphilis was confirmed, but diagnosis of neurosyphilis was only probable based on the CSF microbiological test results. The beneficial treatment response to application of the therapeutic protocol for syphilis supported the supposed diagnosis of syphilis-associated myelitis in our case. In this case report we reviewed the differential diagnostic tools of myelopathies/myelitis.<br>Nowadays regarding to growing prevalence of syphilis worldwide physicians should face on its presence and medical consequences.</p>.

<p>Paraparesis h&aacute;tter&eacute;ben igazol&oacute;dott myelitis transversa differenci&aacute;ldiagnosztikai kihív&aacute;st jelentő eset&eacute;t mutatjuk be egy 42 &eacute;ves nőbetegn&eacute;l. A r&eacute;szletes kivizsg&aacute;l&aacute;s eredm&eacute;nyek&eacute;nt a syphilis egy&eacute;rtelműen igazol&oacute;dott, a myelitis h&aacute;tter&eacute;ben a liquor mikrobiol&oacute;giai eredm&eacute;nyei, a liquor rutinvizsg&aacute;lata &eacute;s a klinikai t&uuml;netek alapj&aacute;n a val&oacute;színűsíthető neurosyphilis diagn&oacute;zis volt fel&aacute;llíthat&oacute;. Eset&uuml;nkben a syphilis kezel&eacute;si protokollja alapj&aacute;n alkalmazott antibiotikum-kezel&eacute;sre adott j&oacute; ter&aacute;pi&aacute;s v&aacute;lasz a neurosyphilis diagn&oacute;zis&aacute;t val&oacute;színűsíti. Jelen esetismertet&eacute;s kapcs&aacute;n &aacute;ttekintj&uuml;k a myelopathia/myelitis differen-ci&aacute;ldiagnosztikai lehetős&eacute;geit.<br>Napjainkban a syphilis vil&aacute;gszintű terjed&eacute;se miatt a t&eacute;m&aacute;val kapcsolatos tud&aacute;sunk bővít&eacute;se sz&uuml;ks&eacute;ges.</p>.

Keywords: neuro-syphilis; paraparesis; syphilis; transverse myelitis.

Publication types

  • Review
  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Myelitis, Transverse*
  • Neurosyphilis* / complications
  • Neurosyphilis* / diagnosis
  • Neurosyphilis* / drug therapy
  • Prevalence
  • Syphilis* / cerebrospinal fluid
  • Syphilis* / complications
  • Syphilis* / diagnosis