EUROSYPHILIS, EYES DON’T SEE WHAT MIND DOESN’T KNOW. AN OLD TREATABLE DISEASE WITH WHITE MATTER LESION JUST LIKE MULTIPLE SCLEROSIS IN A YOUNG PATIENT

Multiple Sclerosis in A Young Patient

Abstract

Syphilis is a bacterial infection caused by spirochete bacterium treponemapallidum. It is transmitted from one person to another through direct contact during sexual intercourse. During pregnancy the infection can also pass from mother to her child. Men who have sex with men are showing fastest rise in syphilis cases. Highest risk populations are young adults aged between 15 to 25 years. Neurosyphilis can occur anytime during the course of syphilis, it was rampant in the preantibiotic era whereas in the modern world it is considered a disease of the past and is rarely seen. However it is resurfacing the medical literature with sporadic cases being reported from all over the world. Here we are reporting a young male who presented with spasticity and ataxia; on investigation he had white matter lesions on MRI in the brain and spinal cord. His CSF showed pleocytosis and his blood and CSF serology was positive for syphilis. The patient later on confirmed sexual contacts in the past hence diagnosis was confirmed and he responded very well to treatment with nearly complete recovery. It is of prime importance to consider this disease in neurological differential diagnosis so as to identify this disease as early as possible and to reduce the mortality risk associated with delayed diagnosis.
Keywords: Syphilis is a bacterial infection caused by spirochete bacterium treponemapallidum. It is transmitted from one person to another through direct contact during sexual intercourse. During pregnancy the infection can also pass from mother to her child. Men who have sex with men are showing fastest rise in syphilis cases. Highest risk populations are young adults aged between 15 to 25 years. Neurosyphilis can occur anytime during the course of syphilis, it was rampant in the preantibiotic era whereas in the modern world it is considered a disease of the past and is rarely seen. However it is resurfacing the medical literature with sporadic cases being reported from all over the world. Here we are reporting a young male who presented with spasticity and ataxia; on investigation he had white matter lesions on MRI in the brain and spinal cord. His CSF showed pleocytosis and his blood and CSF serology was positive for syphilis. The patient later on confirmed sexual contacts in the past hence diagnosis was confirmed and he responded very well to treatment with nearly complete recovery. It is of prime importance to consider this disease in neurological differential diagnosis so as to identify this disease as early as possible and to reduce the mortality risk associated with delayed diagnosis.
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