title: Neurosyphilis Mimicking Ramsay Hunt Syndrome.
abstract: A 36-year-old man presented with facial nerve palsy, hearing loss, vertigo and headache. He was initially diagnosed with Ramsay Hunt syndrome and treated with a systemic steroid and valaciclovir; however, his symptoms deteriorated. Serum rapid plasma reagin (RPR) and treponema pallidum hemagglutination tests were positive. Cerebrospinal fluid analysis revealed an elevated white blood cell count and positive RPR, confirming the diagnosis of neurosyphilis. Penicillin G (PCG) was administered, and his facial nerve function and headache improved. However, left-side hearing loss worsened temporarily, which was assumed to be a Jarisch-Herxheimer reaction. Betamethasone was administered along with PCG, and he recovered completely.
authors.affiliation: Department of General Medicine and Emergency Care, Toho University School of Medicine.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Maeda
authors.forename: Sadako
authors.initials: S
authors.lastname: Yoshizawa
authors.forename: Takehisa
authors.initials: T
authors.lastname: Hirayama
authors.forename: Tomoo
authors.initials: T
authors.lastname: Saga
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tateda
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Urita
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D016697:Herpes Zoster Oticus / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy