title: Neurosyphilis: An Unresolved Case of Meningitis.
abstract: Neurosyphilis can cause both symptomatic and asymptomatic meningitis. However the epidemiology of modern neurosyphilis is not well defined because of the paucity of population-based data. The majority of neurosyphilis cases have been reported in HIV-infected patients. Here we present a case of early neurosyphilis/symptomatic syphilitic meningitis in a non-HIV patient who presented with rash but was mistakenly treated for early latent or secondary syphilis. Syphilis presenting with a skin rash and an extremely high RPR titer could indicate CNS infection rather than simply secondary syphilis because rash is a nonspecific manifestation of disseminated infection. Given the effectiveness of penicillin therapy, why is the rate of syphilis continuing to increase? Is it due to a failure of prevention or could it be also because of failure to diagnose and treat syphilis adequately, as in this case?
authors.affiliation: Saint Michael's Medical Center, 111 Central Avenue, Newark, NJ 07102, USA.
authors.forename: Shagufta
authors.initials: S
authors.lastname: Ahsan
authors.affiliation: International Lyme and Associated Diseases Society, Bethesda, MD 20827-1461, USA.
authors.forename: Joesph
authors.initials: J
authors.lastname: Burrascano