Five-year experience of neurosyphilis cases in a tertiary care hospital in Turkey

Abstract

Aim: To evaluate retrospectively the cases of syphilis who applied to different clinics of our hospital in the last 5 years and to emphasize the importance of admission screening tests in the diagnosis of neurosyphilis which is a rare but serious form of syphilis.

Methods: Sixty-one patients who admitted to different clinics of our hospital between 2013 and 2017 with different clinical manifestations and positive Venereal Disease Research Laboratory (VDRL) and Treponema pallidum microhemagglutination assay (TPHA) tests were recorded and analyzed retrospectively.

Results: Both VDRL and TPHA tests were positive in 44 males with a mean age of 57.4 ± 18.4 years and 17 females with a mean age of 65.3 ± 19.1 years. It was found that of the 61 patients who were examined for differential diagnosis of syphilis, 36 (%59) of them were referred from neurology clinic, 15 (25%) from infectious diseases clinic, 7 (12%) from dermatology clinic and 3 (4%) from gynecology clinic.   The clinical presentation was venereal chancre in 15 cases, asymptomatic ischemic brain lesions in 17 cases, acute ischemic stroke in 13 cases, movement disorder in three cases, tabes dorsalis in two cases, tendinitis-arthritis in eight cases, Amyotrophic lateral sclerosis (ALS) in one case, Deep venous thrombosis (DVT) in one case, and pulmonary nodule in one case. 

Conclusions: In conclusion, syphilis is often overlooked in the differential diagnosis in patient with neurological findings. Since neurosyphilis is an easily treatable disease, it should be considered in the differential diagnosis of patients presenting with neurological findings.