Seronegative dementia paralytica: report of a case.
Dementia paralytica may present diagnostic difficulties when routine serological test using a non-treponemal antigen is non-reactive. We present an illustrative demented patient who initially had negative VDRL test both in his serum and cerebrospinal fluid. However, the brain biopsy specimen showed active meningoencephalitis. By special staining technique, a spiral organism was found in the brain exhibiting morphology perfectly compatible with treponema pallidum. Later in the course, the VDRL became reactive in the blood but remained non-reactive in the cerebrospinal fluid. On the basis of the experience of other workers in the field and ours with this patient, we advise the use of FTA-ABS test as a screening procedure in patients with neurological problems of possible syphilitic origin. We urge further research in this field.
D000328:Adult; D001706:Biopsy; D001921:Brain / Q000382:microbiology / Q000473:pathology; D003704:Dementia; D006801:Humans; D008297:Male; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum / Q000302:isolation & purification