Gosford Hospital, Gosford, New South Wales, Australia.
Gosford Hospital, Gosford, New South Wales, Australia
BMJ Case Rep. 2021 Jun 28;14(6):e241765. doi: 10.1136/bcr-2021-241765.
Syphilis is increasingly prevalent in the community. The protean manifestations of neurosyphilis make the recognition, diagnosis and early initiation of treatment challenging. We report a case of early syphilitic meningitis presenting with multiple cranial neuropathies. Cerebrospinal fluid (CSF) examination was inflammatory with predominant lymphocytosis. The patient was diagnosed with neurosyphilis based on serum as well as CSF testing. Intravenous benzylpenicillin treatment resulted in rapid improvement of neurological symptoms. Neurosyphilis should be considered in immunocompetent patients presenting with multiple cranial neuropathies, or isolated cranial neuropathies without vascular risk factors.
梅毒在社区中越来越普遍。神经梅毒的多种表现形式使得识别、诊断和早期开始治疗具有挑战性。我们报告了一例早期梅毒性脑膜炎，表现为多种颅神经病变。脑脊液（CSF）检查呈炎症性，以淋巴细胞为主。根据血清和 CSF 检测结果，该患者被诊断为神经梅毒。静脉注射苄星青霉素治疗后，神经症状迅速改善。对于表现为多种颅神经病变或无血管危险因素的孤立性颅神经病变的免疫功能正常的患者，应考虑神经梅毒。
