Man diagnosed with rare syphilis infection in brain after struggling to walk, talk

A man was diagnosed with a syphilis infection in the brain, known as neurosyphilis, after he struggled to walk and talk normally for months, according to a recent case report.

The 50-year-old man’s case was detailed in the British Medical Journal Case Reports (BMJ). Doctors did not identify the man.

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Three months before he sought treatment, the man reportedly lost his coordination and “developed tremors and uncontrolled eye movements,” according to the Daily Mail, which reviewed the report. He also had trouble speaking properly.

A brain MRI later revealed the man – who denied “high-risk sexual exposure or any previous history of genital infections or ulcers,” doctors wrote in the report  – had damage to his cerebellum, the part of the brain that controls balance and speech, among other things.

The man’s case of ataxia, which “describes a lack of muscle control or coordination of voluntary movements,” according to the Mayo Clinic, was also connected to the damage found in his cerebellum.

The scan revealed the man had neurosyphilis.

The scan revealed the man had neurosyphilis. (BMJ Case Reports 2019)

Further tests revealed the man was positive for Treponema pallidum, a type of bacteria that causes syphilis — a sexually transmitted infection that first appears as a small, painless sore.

Doctors determined he had neurosyphilis, a rare infection which typically occurs if an initial syphilis infection is left untreated.

“Neurosyphilis tends to develop about 10 to 20 years after the initial infection with the bacterium. Having HIV and untreated syphilis are major risk factors for neurosyphilis,” per Healthline. 

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There are five different forms of neurosyphilis — asymptomatic, meningeal, meningovascular, general paresis and tabes dorsalis — but, according to doctors who treated the man, he did not fall into any of those categories and did not exhibit any of the more common signs, such as nausea, vomiting or a stiff neck.

The man was treated with antibiotics for two weeks and also underwent physiotherapy. He eventually recovered and relearned how to walk properly, doctors said.