alexa Syphilis a Reversible Cause of Dementia | Open Access Journals
ISSN: 2167-7182
Journal of Gerontology & Geriatric Research
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Syphilis a Reversible Cause of Dementia

Ishrat Ansari* and George T. Grossberg
Division of Geriatric Psychiatry, St Louis University School of Medicine, Missouri, USA
Corresponding Author : Ishrat Ansari
Division of Geriatric Psychiatry
Department of Neurology & Psychiatry
St Louis University School of Medicine
Missouri, USA
Tel:
3149969689
E-mail: [email protected]
Received: August 12, 2015 Accepted: August 25, 2015 Published: August 27, 2015
Citation: Ansari I and Grossberg GT(2015) Syphilis a Reversible Cause of Dementia. J Gerontol Geriatr Res S4:003. doi: 10.4172/2167-7182.S4-003
Copyright: © 2015 Ansari I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Keywords
Neurosyphilis; Mild to moderate neurocognitive impairment and reversible dementia
Introduction
This is a case of a patient who presented to our Geriatric Psychiatry Division with Major Depressive Disorder, severe, recurrent with psychotic features and mild cognitive impairment with bilateral lower extremity pain. Patient was diagnosed with Neurosyphilis
Case Report
This article describes a case of a 71-year-old patient of Ethiopian background who presented to the Geriatric Psychiatry inpatient unit for worsening of depression and memory problems with progressive cognitive decline and behavioral changes over the last several years. The patient also had persecutory delusions and was unable to perform ADL’s and IADL’s. The patient had previous multiple psychiatric hospitalizations for major depressive disorder, severe, recurrent with psychotic features and was treated with antidepressants and antipsychotics without any significant improvement in symptoms. Patient also reported bilateral lower extremity pain. We performed a complete clinical and laboratory work up for reversible cause of dementia. CSF analysis showed raised protein and cell count. The diagnosis of Neurosyphilis was established based on positive serum RPR and FTA-ABS tests along with neurological and behavioral sign and symptoms. Patient was treated with high dose penicillin for 10 days. At one year follow up improvement was noted clinically and the patient was able to perform her ADL’s and IADL’s along with improvement of depression and psychotic features.
Conclusion
Often there are times when “reversible dementias” do not present with cognitive or behavioral symptoms that are severe enough to meet the criteria of major or mild cognitive impairment. It is prudent to diagnose and treat mild cognitive impairment with reversible etiology in psychiatric settings. This case stresses the import of performing the screening test for reversible causes of dementia including RPR, especially in patients with a background where syphilis is prevalent along with cognitive impairment with neurological signs. While the etiologies of reversible dementia may be treatable, and improves the patient’s overall functioning, full reversal of symptoms of dementia should not be assumed.
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