title: [Meningovascular neurosyphilis as the cause of ischemic cerebrovascular disease in a young man].
abstract: Authors report a case of a 35-year-old male with right-sided mild paresis, incontinence, dysexecutive syndrome, short-term memory loss and behavioral changes. Bilateral cerebral infarcts in the region of the caudate nuclei and the adjacent white matter were proved by brain MRI and multiple stenoses of the branches of Willis-circle were confirmed by MR angiography. Elevated protein level and pleocytosis were found in the cerebrospinal fluid with intrathecal IgG synthesis. Serum rapid plasma reagin, Treponema pallidum Particle Agglutination test, Treponema pallidum ELISA, liquor Venereal Disease Research Laboratory tests were positive. Meningovascular neurosyphilis was diagnosed. 24M U/day intravenous penicillin-G treatment was given for 14 days. The patient has vascular dementia due to the bilateral strategic infarcts disconnecting the prefrontal circuits; his symptoms are similar to general paresis. Laboratory and radiologic improvement was observed. Still, the patient have severe residual cognitive decline.
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest. toveroka@yahoo.com
authors.forename: Veronika
authors.initials: V
authors.lastname: Tóth
authors.forename: Csilla
authors.initials: C
authors.lastname: Hornyák
authors.forename: Tibor
authors.initials: T
authors.lastname: Kovács
authors.forename: Béla
authors.initials: B
authors.lastname: Tóth
authors.forename: György
authors.initials: G
authors.lastname: Várallyay
authors.forename: Eszter
authors.initials: E
authors.lastname: Ostorházi
authors.forename: József
authors.initials: J
authors.lastname: Köles
authors.forename: Dániel
authors.initials: D
authors.lastname: Bereczki
authors.forename: Márta
authors.initials: M
authors.lastname: Marschalkó
authors.forename: Sarolta
authors.initials: S
authors.lastname: Kárpáti
mesh_terms: D000328:Adult; D000372:Agglutination Tests; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002561:Cerebrovascular Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D015140:Dementia, Vascular / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008578:Meninges / Q000098:blood supply / Q000382:microbiology; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy*; D010291:Paresis / Q000382:microbiology; D010400:Penicillin G / Q000008:administration & dosage*; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G