Skip to main navigation menu Skip to main content Skip to site footer

Case Report

Vol. 11 No. 2 (2008)

Neurosyphilis in a Non-HIV Patient: More than a Psychiatric Concern

  • Michael K Tso
  • Kevin Koo
  • Grace Y Tso
November 7, 2020


Neurosyphilis is a form of tertiary syphilis infection caused by the spirochete bacterium Treponema pallidum. Patients suffering from this illness can present with neurological manifestations such as headaches, seizures, hearing loss, and ataxia. However, the typical presentation of neurosyphilis is the insidious onset of psychiatric symptoms including personality changes.Agood history and clinical work-up is essential in the diagnostic process. There has been a recent increase in the incidence of infectious syphilis in Canada (1). However, in other parts of the world including China, infectious syphilis rates have remained high due to limited access to primary care and affordable treatments (2). Here, we present a case of neurosyphilis in a 40 year old Chinese male residing in China who presents with an 18 month history of personality changes as well as neurological and physical manifestations of the infection.


  1. Public Health Agency of Canada. 2004 Canadian Sexually Transmitted Infections Surveillance Report. CCDR 2007; 33S1:1-69.
  2. Lin CC, Gao X, Chen, X-S, Chen Q and MS Cohen. China’s Syphilis Epidemic: A Systematic Review of Seroprevalence Studies. Sexually Transmitted Diseases. December 2006; 33(12):726-736.
  3. Goldon MR, Marra CM and KK Holmes. Update on Syphilis: Resurgence of an old problem. JAMA 2003; 290:1510-1514.
  4. Goh BT. Syphilis in Adults. Sexually Transmitted Infections 2005; 81: 448-452.
  5. Wasserheit JN. Epidemiological synergy: Interrelationshipsbetween human immunodeficiency virus infection and other sexually transmitted diseases. Sexually Transmitted Diseases. March-April 1992; 19(2):61-77.
  6. LaFond RE and SA Lukehart. Biological Basis for Syphilis. Clin Microbiol Rev. 2006 January; 19(1): 29–49.
  7. French P. Clinical Review: Syphilis. BMJ 2007; 334:143-7.
  8. Mandell GL, Bennett JE and R Dolin. Mandel, Douglas, and Bennett’s: Principles and Practice of Infectious Diseases. 6th edition. Churchill Livingstone. 2005. Chapter 235.
  9. Cohen J, Powderly WG, et al. Cohen & Powderly: Infectious Diseases. 2nd edition. Mosby. 2004. Chapter 75.
  10. Birnbaum NR, Goldschmidt RH, andWO Buffett. Resolving the common clinical dilemmas of syphilis.Am Fam Physician. 1999 April; 59(8):2233-40, 2245-6.
  11. Jaffe HW, Larsen SA, Peters M, et al. Tests for treponemal antibody in CSF. Arch Intern Med 1978; 138:252.
  12. Marra CM, Maxwell CL, Smith SL, et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis 2004; 189: 369-79.
  13. Hicks CB. Serologic testing for syphilis. 2006.
  14. Drugs for Sexually transmitted diseases. Treat Guidel Med Lett 2004; 2:67


Download data is not yet available.