title: Neuropsychiatric disorders secondary to neurosyphilis in elderly people: one theme not to be ignored.
abstract: BACKGROUND
  Neurosyphilis (NS) may present with neuropsychiatric disorders characterized by cognitive impairment, personality disorders, and confusion, among others. Very few studies have focused on neuropsychiatric disorders secondary to NS in elderly people.
  
  
  METHODS
  A retrospective chart review was performed to characterize the psychiatric findings, clinical signs and symptoms, laboratory findings, and brain magnetic resonance imaging results of ten elderly inpatients with NS.
  
  
  RESULTS
  In these ten patients, the most common presenting symptoms included a wide variety of psychiatric manifestations. The serum rapid plasma regain (RPR) and Treponema pallidum particle agglutination assay (TPPA) of the ten patients were positive, with positive CSF TPPA and RPR rates of 100% and 60%, respectively. In addition, 90% of the patients demonstrated abnormal imaging, including cerebral atrophy, infarct ischemic stroke, and hydrocephalus.
  
  
  CONCLUSIONS
  Our findings support the importance of serological tests for syphilis as a routine component of the evaluation of patients with clinically evident neurological or psychiatric symptoms. If the serology is positive, all of the patients should be examined with a lumbar puncture. Moreover, psychiatric illnesses secondary to NS in the elderly also deserve medical attention.
authors.affiliation: Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Zeng
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Wang
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Zhang
authors.forename: Fu-Yi
authors.initials: FY
authors.lastname: Chen
authors.forename: Song-Jie
authors.initials: SJ
authors.lastname: Huang
authors.forename: Gui-Li
authors.initials: GL
authors.lastname: Liu
authors.forename: Ya
authors.initials: Y
authors.lastname: Xi
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Guo
authors.forename: Wei-Hong
authors.initials: WH
authors.lastname: Zheng
authors.forename: Tian-Ci
authors.initials: TC
authors.lastname: Yang
mesh_terms: D000368:Aged; D000372:Agglutination Tests / Q000379:methods; D002681:China; D003072:Cognition Disorders / Q000503:physiopathology; D004569:Electroencephalography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D009494:Neurosyphilis / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D011935:Reagins / Q000097:blood; D012189:Retrospective Studies; D012698:Serologic Tests / Q000379:methods; D013129:Spinal Puncture; D013588:Syphilis Serodiagnosis / Q000379:methods*; D014210:Treponema pallidum / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D011935:Reagins