Carranza Octavio, Waheed Sadia, Yousuf Fawad
Neurology, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Cureus. 2024 Mar 17;16(3):e56330. doi: 10.7759/cureus.56330. eCollection 2024 Mar.
A male in his 60s with stroke risk factors presented with confusion and word-finding difficulties. He was diagnosed with acute ischemic stroke in the right basal ganglia. He was started on secondary stroke prevention measures including dual antiplatelet therapy and a high-dose statin. A highly reactive rapid plasma reagin (RPR) was performed as part of the workup and found to be positive. Follow-up fluorescent treponemal antibody absorption (TPA) test was also positive, confirming a diagnosis of syphilis. He was discharged home with a scheduled course of antibiotic treatment for tertiary syphilis but returned due to a new episode of transient facial paralysis. Further workup and physical exam findings revealed the patient had neurosyphilis. He was started on the appropriate antibiotic therapy, which significantly improved his confusion and prevented new episodes of stroke.
一名60多岁有中风风险因素的男性出现意识模糊和找词困难。他被诊断为右侧基底节区急性缺血性中风。他开始接受二级中风预防措施，包括双重抗血小板治疗和高剂量他汀类药物治疗。作为检查的一部分，进行了高反应性快速血浆反应素（RPR）检测，结果呈阳性。后续的荧光密螺旋体抗体吸收（TPA）试验也呈阳性，确诊为梅毒。他出院回家，安排了三期梅毒的抗生素治疗疗程，但因新出现的短暂性面瘫再次就诊。进一步的检查和体格检查结果显示该患者患有神经梅毒。他开始接受适当的抗生素治疗，这显著改善了他的意识模糊，并预防了中风的新发作。
