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Whether non-venereal treponematosis infection can cause neurological complications remains uncertain. We present a case of an elderly man with a childhood history of yaws infection and positive syphilis serology presenting with rapidly progressive dementia and neuropsychiatric symptoms consistent with neurosyphilis. The patient passed away one year from the onset of symptoms following a rapid downhill course. Given the effectiveness of antibiotic treatment, clinicians should be highly suspicious of the possibility of central nervous system involvement in patients with a prior history of non-venereal treponematosis.