Clinical case of meningovascular syphilis in combination with HIV infection

• Main Authors: S. Ya. Kyryliuk, T. I. Nehrych, Ya. Ye. Sanotskyi
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2019-06-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: cerebral infarction; neurosyphilis; meningitis; HIV infection
• Online Access: http://zmj.zsmu.edu.ua/article/view/169221/169317

Purpose: to study the features of clinical course, diagnosis and treatment of meningovacular syphilis associated with HIV infection. Materials and methods. Clinical case of meningovascular syphilis in the context of HIV infection in a 55-year-old man, methods of diagnosis and treatment. Results. The article deals with a special case of meningovascular syphilis associated with HIV in the man of 55 years, as well as the features of the clinical course and treatment of this pathology are discussed based on the analysis of the professional literature data. The data of anamnesis, objective, laboratory and instrumental examination, results of patient's treatment are presented. It is noted that a stroke may be the first manifestation of neurosyphilis and HIV infection. Changes in the cerebrospinal fluid were accompanied by a slight increase in lymphocytes. Specific immunological examination of blood and liquor was the key to the diagnosis. Treatment with ceftriaxone has resulted in improvement of the patient's health condition and a regression of motor neurologic deficit. Conclusions. Patients with HIV infection are vulnerable to cerebrovascular diseases due to various etiological factors. Meningovascular form of neurosyphilis may be the initial manifestation of syphilis in both HIV-positive and HIV-negative individuals. Due to the increased incidence of syphilis, as well as co-infection with HIV, it is recommended to examine young patients with a stroke of unknown etiology with a presence of undetermined neurological symptoms and changes in the cerebrospinal fluid for HIV and syphilis. Clinical manifestations of neurovascular syphilis tend to be regressed in the course of specific antibiotic therapy.