King Christopher J, Ngo Teresa H, Constante Martin
Neurology, Western University of Health Sciences, Pomona, USA.
Neurology, San Antonio Regional Hospital, Upland, USA.
Cureus. 2023 Mar 20;15(3):e36405. doi: 10.7759/cureus.36405. eCollection 2023 Mar.
Neurosyphilis occurs when the spirochete invades the cerebrospinal fluid (CSF). Clinical presentation depends on an individual's immune response and invasion location, with all possible involvement of meningeal, vascular, and/or parenchymatous tissues. Meningovascular neurosyphilis occurs when both the meninges and vasculature are affected and can lead to headaches, photophobia, neck stiffness, cranial nerve palsies, and/or ischemic brain infarctions due to infectious arteritis. The following report describes the rare case of a 32-year-old male patient presenting with multiple ischemic brain infarctions of varying ages. The stepwise diagnostic approach as described allowed the medical team to reach the final diagnosis of meningovascular neurosyphilis with concomitant acquired immunodeficiency syndrome (AIDS). This case emphasizes the importance of maintaining high clinical suspicion in all young adult patients who present with acute neurological deficits.
当梅毒螺旋体侵入脑脊液（CSF）时，就会发生神经梅毒。临床表现取决于个体的免疫反应和感染部位，脑膜、血管和/或实质组织都有可能受累。当脑膜和血管均受到影响时，就会发生脑膜血管性神经梅毒，可导致头痛、畏光、颈部僵硬、颅神经麻痹和/或由于感染性动脉炎引起的缺血性脑梗死。以下报告描述了一名32岁男性患者出现不同年龄的多发性缺血性脑梗死的罕见病例。所述的逐步诊断方法使医疗团队最终诊断为脑膜血管性神经梅毒合并获得性免疫缺陷综合征（AIDS）。该病例强调了对所有出现急性神经功能缺损的年轻成年患者保持高度临床怀疑的重要性。
