Manifest psychosis in neurosyphilis.
BACKGROUND
Recent surveys have assessed a remarkable increase in the prevalence of infectious syphilis. If left untreated, 30% of patients may develop tertiary syphilis, which can manifest as neurosyphilis.


METHODS
The authors present a case of an acute psychosis during and after pregnancy in a 37-year-old woman, which was identified as a manifestation of neurosyphilis after admission to a psychiatric ward. The positive screening test for syphilis provided the first hint of syphilis and gave direction for further diagnosis and specific treatment. Subsequently, the patient was treated with psychotropic medication concurrent with an adequate antibiotic treatment for neurosyphilis and was simultaneously psychologically monitored. An improvement of psychotic symptoms during antibiotic therapy was observed.


CONCLUSIONS
This case emphasises that neurosyphilis still has to be considered in the differential diagnosis within the context of psychiatric conditions and diseases. Owing to current epidemiological data and difficulties in diagnosing syphilis, routine screening tests in the psychiatric field are necessary.
Friedrich
Fabian
F
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna 1090, Austria. fabian.friedrich@meduniwien.ac.at
Geusau
Alexandra
A
Greisenegger
Stefan
S
Ossege
Michael
M
Aigner
Martin
M
D000328:Adult; D002308:Cardiolipins; D002784:Cholesterol; D003702:Delusions / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D019052:Depression, Postpartum / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D016508:Fluorescent Treponemal Antibody-Absorption Test; D006801:Humans; D008403:Mass Screening; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D010713:Phosphatidylcholines; D010819:Physician's Role; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000458:organization & administration; D012563:Schizophrenia, Paranoid / Q000150:complications; D013129:Spinal Puncture
D002308:Cardiolipins; D010713:Phosphatidylcholines; C054448:VDRL antigen; D002784:Cholesterol