Case report: neurosyphilis imitator of acute ischemic stroke

Abstract

Background. 40% of patients with syphilis can be affected by the spirochetal invasion of the central nervous system. Neurosyphilis can be presented with stroke signs in 14,09% of patients, and the misdiagnosis rate in such cases can reach up to 80,95% [1-4]. Materials and methods. A case of a 74-year-old patient with ischemic stroke due to meningovascular syphilis will be reported. Objective. Presentation of a diagnostic pathway in case of suspected stroke due to neurosyphilis, with an evaluation of the clinic-imagistic correlation. Results. The patient was admitted to the hospital, with sudden onset of speech disturbances, right-side hemiparesis, and neck rigidity. Conclusions. Neurosyphilis can mimic acute ischemic stroke, presented by similar clinical signs and neuroimaging findings; the serological tests are crucial for diagnosis. Due to the fact that therapeutic approaches differ in case of neurosyphilis, DD is very important.