Neurosyphilis presenting as acute ischemic stroke.
Neurosyphilis presenting as acute ischemic stroke.
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DOI：
10.7861/clinmed.2019-0368
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发表时间：
2020-01
影响因子：
4.4
通讯作者：
Dhayalen Krishnan;Siti Sm Zaini;K. A. Latif;J. Joseph
中科院分区：
文献类型：
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作者：
Dhayalen Krishnan;Siti Sm Zaini;K. A. Latif;J. Joseph
神经梅毒是一个广义的术语，用于描述由梅毒螺旋体引起的中枢神经系统感染。虽然这是19世纪中风的常见原因，但在引入青霉素后，它有所下降。然而，在最近的过去，梅毒的发病率有所增加，特别是与艾滋病毒合并感染。神经梅毒是由未经治疗的原发性梅毒引起的。神经精神障碍是最常见的表现，其次是脑血管意外、脊髓病、眼病和癫痫发作。然而，这个被称为“伟大的模仿者”的实体，如果不是因为高度的怀疑，可能很容易被忽视。这一点尤其如此，因为它的表现与其他更常见的临床病症相似。我们描述的情况下，一个39岁的男子显示急性全局失语和右侧面部无力保持与左大脑中动脉梗死。脑部计算机断层扫描证实了这一点，随后，进一步的调查显示出神经梅毒的诊断。患者经静脉注射青霉素治疗，经治疗恢复良好。
Neurosyphilis is a broad term used to describe an infection caused by Treponema pallidum in the central nervous system. While this was a common cause of stroke in the 19th century, it saw a decline after the introduction of penicillin. However, in the recent past, there has been an increase in the incidence of syphilis, especially with HIV coinfection. Neurosyphilis results from an untreated primary syphilis. Neuropsychiatric disorder appears to be the commonest manifestation followed cerebrovascular accident, myelopathy, ocular disease and seizure. Known as the 'great imitator', this entity, however, may be easily missed if not for a high index of suspicion. This is especially so because of its similar presentation to other more common clinical conditions. We describe the case of a 39-year-old man displaying acute global aphasia and right-sided facial weakness in keeping with a left middle cerebral artery infarct. This was confirmed with computed tomography of the brain, and subsequently, further investigations revealed a diagnosis of neurosyphilis. The patient was treated with intravenous benzylpenicillin and recovered well with treatment.