Document Detail


Neurosyphillis presenting with normal pressure hydrocephalus in a 76 year old man.
MedLine Citation:
PMID:  23569521     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Normal pressure hydrocephalus (NPH) is composed of gait abnormalities, urinary incontinence and decline in mentation. It is uncommonly induced by syphilitic infection.
CASE REPORT: A 76 year-old male present with gait disturbances, urinary incontinence, declining vision and cognition, with a known diagnosis of NPH. He underwent therapeutic lumbar puncture (LP), which demonstrated leukocytosis and elevated protein. Venereal disease research laboratory testing (VDRL) was reactive in a 1:64 dilution with positive fluorescent Treponemal Antibody (FTA-Abs). The subject was treated with 14 days of Intravenous (IV) Penicillin 3 million units for 3 weeks and intramuscular benzathine PCN for 2 shots, with marked clinical improvement.
CONCLUSIONS: The incidence of Tabes Dorsalis is limited in the age of penicillin, especially in subjects without HIV. Subjects are diagnosed with either LP RPR or VDRL, confirmed with FTA-Abs. Common treatment is IV PCN 1.4-3 mU for 10-14 days.
Authors:
Shaffer R S Mok; Vivek Punjabi; David L Shklar
Publication Detail:
Type:  Journal Article     Date:  2012-08-07
Journal Detail:
Title:  The American journal of case reports     Volume:  13     ISSN:  1941-5923     ISO Abbreviation:  Am J Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2013-04-09     Completed Date:  2013-04-10     Revised Date:  2014-09-22    
Medline Journal Info:
Nlm Unique ID:  101489566     Medline TA:  Am J Case Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  173-6     Citation Subset:  -    
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