Bindu R S, Aiswarya B H, Nair S Pradeep, Mathew Rony, Gopinath Deepthy V
Department of Dermatology and Venereology, Government Medical College, Thiruvananthapuram, Kerala, India.
Indian J Sex Transm Dis AIDS. 2023 Jul-Dec;44(2):169-172. doi: 10.4103/ijstd.ijstd_1_23. Epub 2023 Dec 6.
A 66-year-old unemployed unmarried male with known men sex men activity since the age of 20 years presented with an erythematous well-defined ulcer on the lower lip and multiple discrete papulo-squamous lesions on the palms, soles, and scrotum. The patient was also in dysphoric mood with grandiose ideas with normal higher function. Knee and ankle jerk reflexes were absent and there was impaired tandem walking. Venereal Disease Research Laboratory (VDRL) and treponema pallidum hemagglutination assay were positive. Cerebrospinal fluid-VDRL was positive with grossly elevated proteins and glucose. HIV test was negative. Magnetic resonance imaging scan of the brain was normal. We made a diagnosis of neurosphilis - General paralysis of insane (GPI) with co-existing early syphilis. The patient was started on crystalline penicillin for 14 days after which there was significant improvement in behavior. We are reporting a rare case of GPI with early syphilis.
一名66岁的失业未婚男性，自20岁起有男男性行为史，下唇出现边界清晰的红斑性溃疡，手掌、足底及阴囊有多处散在的丘疹鳞屑性损害。患者情绪烦躁，有夸大观念，但高级功能正常。膝跳反射和踝反射消失，步态共济失调。性病研究实验室（VDRL）试验和梅毒螺旋体血凝试验均为阳性。脑脊液VDRL阳性，蛋白和葡萄糖明显升高。HIV检测为阴性。脑部磁共振成像扫描正常。我们诊断为神经梅毒——麻痹性痴呆（GPI）合并早期梅毒。患者开始接受结晶青霉素治疗14天，之后行为有显著改善。我们报告一例罕见的GPI合并早期梅毒病例。
