[Progressive paralysis. A case report].
OBJECTIVE
A fairly uncommon case of neurosyphilis is reported in a not immunocompromised patient.


METHODS
A case of general paresis in a 40 year-old male with the recent onset of mania is described. Psychiatric anamnesis was negative. Neurologic examination was negative. Laboratory tests were performed and serologic tests for syphilis were positive. Cerebrospinal fluid (CSF) examination showed 80 leukocytes/mm3, a reactive Venereal Disease Research Laboratory (VDRL) and normal protein concentration. CSF gamma globulin with an oligoclonal pattern and abnormal IgG index were found. A test for antibodies to Human Immunodeficiency Virus (HIV) was negative. The patient underwent a high dose intravenous penicillin G regimen for two weeks. A follow-up six months later showed a normal CSF even though the IgG index was still abnormal and the mental status was unchanged.


CONCLUSIONS
The authors suggest that patients with neurologic and/or psychiatric symptoms with a recent onset and a reactive VDRL should undergo a CSF examination to exclude a possible neurosyphilis.
Trotta
M
M
Unità Operativa Malattie Infettive Azienda USL 10, Antella Azienda Ospedaliera Careggi, Firenze.
Sterrantino
G
G
Meli
M
M
Dionisio
D
D
Regoli
G
G
Leoncini
F
F
D000328:Adult; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007275:Injections, Intravenous; D008297:Male; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000175:diagnosis; D010400:Penicillin G / Q000008:administration & dosage; D013588:Syphilis Serodiagnosis; D013997:Time Factors; D005719:gamma-Globulins / Q000134:cerebrospinal fluid
D002556:Cerebrospinal Fluid Proteins; D007074:Immunoglobulin G; D005719:gamma-Globulins; D010400:Penicillin G
Paralisi progressiva. Descrizione di un caso.