Effectiveness of olanzapine in neurosyphilis related organic psychosis: a case report.

J Psychopharmacol. 2007 Jul;21(5):556-8. Epub  2006 Nov 8.

Source

Department of Psychiatry, Medical Faculty of Istanbul University, Turkey. senolturan81@yahoo.com.tr

Abstract

The clinicians usually do not consider syphilis in the differential diagnosis for patients with acute and chronic psychiatric symptoms. To familiarize clinicians particularly with neurosyphilis (NS) and to discuss the atypical antipsychotic alternatives, we wish to present a case with agitated, resistant psychotic symptoms related to neurosyphilis. The case was a 55-year-old male who has had anxiety, irritability, auditory hallucinations, ataxia, dysarthric speech, paranoid and persecutory delusions and agitated behaviour. Parenteral ziprasidone 20 mg/bid was initialized at the first day of admission to reduce agitation. Then it was switched to olanzapine velotab 10 mg/bid because of inefficacy. Parenteral cephtriaxon 1 g/daily was administered because of seropositive VDRl and TPHA and positive cerebrospinal fluid VDRl. Olanzapine velotab may be a good alternative antipsychotic and should be considered in reducing agitation and psychotic symptoms in NS.

PMID:
17092977
[PubMed – indexed for MEDLINE]

A late form of neurosyphilis manifesting with psychotic symptoms in old age and good response to ceftriaxone therapy.

Int Psychogeriatr. 2011 May;23(4):666-9. Epub  2010 Sep 15.

Source

Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.

Abstract

Neurosyphilis can present with psychiatric symptoms. The late form can occur in old age with psychosis, paranoid delusions, affective disorders or cognitive impairment. Here we present a case of neurosyphilis in an elderly woman who, over six months, progressively manifested personality changes and paranoid delusions which were initially suspected as Alzheimer’s disease. Psychotic symptoms showed a good response to antibiotic treatment. We conclude that neurosyphilis is a relevant differential diagnosis in patients developing severe psychiatric symptoms in old age. As a causal antibiotic treatment is possible this infectious disease should be considered seriously in gerontopsychiatric patients.

PMID:
20843397
[PubMed – indexed for MEDLINE]

Manifest psychosis in neurosyphilis.

Gen Hosp Psychiatry. 2009 Jul-Aug;31(4):379-81. Epub  2008 Oct 9.

Source

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna 1090, Austria. fabian.friedrich@meduniwien.ac.at

Abstract

INTRODUCTION:

Recent surveys have assessed a remarkable increase in the prevalence of infectious syphilis. If left untreated, 30% of patients may develop tertiary syphilis, which can manifest as neurosyphilis.

CASE REPORT:

The authors present a case of an acute psychosis during and after pregnancy in a 37-year-old woman, which was identified as a manifestation of neurosyphilis after admission to a psychiatric ward. The positive screening test for syphilis provided the first hint of syphilis and gave direction for further diagnosis and specific treatment. Subsequently, the patient was treated with psychotropic medication concurrent with an adequate antibiotic treatment for neurosyphilis and was simultaneously psychologically monitored. An improvement of psychotic symptoms during antibiotic therapy was observed.

CONCLUSION:

This case emphasises that neurosyphilis still has to be considered in the differential diagnosis within the context of psychiatric conditions and diseases. Owing to current epidemiological data and difficulties in diagnosing syphilis, routine screening tests in the psychiatric field are necessary.

PMID:
19555800
[PubMed – indexed for MEDLINE]

Neurosyphilis presenting as mania.

Bipolar Disord. 2012 May;14(3):309-12. doi: 10.1111/j.1399-5618.2012.01007.x.

Source

Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. izabelagb@gmail.com

Abstract

OBJECTIVE:

General paresis of the insane is a late and severe form of neurosyphilis characterized by nonspecific neuropsychiatric symptoms. There are a limited number of case reports of mood disorders presenting in neurosyphilis, with depressive illness being the most common.

METHODS:

We performed a literature review of case reports of secondary bipolar disorder induced by syphilitic infection.

RESULTS:

Herein reported is a case of a 53-year-old woman who initially presented with symptoms of mania and depression, mimicking bipolar disorder, but was subsequently diagnosed with general paresis of the insane.

CONCLUSION:

The present case report emphasizes that if a substantial delay occurs in syphilis diagnosis and management, the patient may have a very poor prognosis.

© 2012 John Wiley and Sons A/S.

Up ↑