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Ceftriaxone treatment for two neurosyphilis cases presenting with cognitive and psychiatric symptoms [Turk J Neurol]
Turk J Neurol. 2011; 17(2): 96-101

Ceftriaxone treatment for two neurosyphilis cases presenting with cognitive and psychiatric symptoms

Melek Kandemir1, Zerrin Pelin2, Ece Yazla3, Cem İsmail Küçükali4
1Department of Neurology, Medical Park Göztepe Hospital, İstanbul, Turkey
2Department of Neurology, Erenkoy Psychiatry and Neurology Education and Research Hospital, İstanbul, Turkey
3Department of Psychiatry, Erenkoy Psychiatry and Neurology Education and Research Hospital, İstanbul, Turkey.
4Department of Neurology, İstanbul University, İstanbul, tURKEY

Syphilis is a disease caused by the spirochetal bacterium Treponema Pallidum subspecies pallidum. The route of transmission of syphilis is almost always through sexual contact. The incidence of syphilis decreased significantly with the introduction of penicilin in the 1940s but rose sharply again with the advent of HIV infection in the 1980s. Tertiary or late syphilis develops years after the initial infection and can involve any organ system. Neurologic involvement occurs in up to 10 percent of patients with untreated syphilis. General paresis, the clinical form of neurosyphilis most associated with psychiatric symptoms, occurs with parenchymatous disease and involves neuronal loss as opposed to the vascular lesions or inflammatory changes characteristic of most other forms of neurosyphilis. In the classic description, after early psychiatric manifestations such as mood changes, psychosis, or cognitive changes, demantia becomes prominent. Penicillin is the only drug that has proved effective in the treatment of neurosyphilis. Ceftriaxone is used as an alternative treatment in patients with penicilin allergy. This article reports two cases of neurosyphilis one of whom is presented with dementia and the other with psychiatric symptoms. Both of them are treated with ceftriaxone. Our purpose is to reveal the fact that ceftriaxone is a succesful alternative treatment for the cases with penicilin allergy and to emphasize the importance of neurosyphilis in the differential diagnosis for the psychiatric cases that are resistant to treatment.

Keywords: Neurosyphilis, neurosyphilis and psychiatry, neurosyphilis and ceftriaxone


Melek Kandemir, Zerrin Pelin, Ece Yazla, Cem İsmail Küçükali. Ceftriaxone treatment for two neurosyphilis cases presenting with cognitive and psychiatric symptoms. Turk J Neurol. 2011; 17(2): 96-101

Corresponding Author: Ece Yazla, Türkiye


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