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]
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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 schizophrenialike psychosis.

Source

Department of Psychiatry, University of Pennsylvania, Philadelphia 19104-4283, USA.

Abstract

OBJECTIVE:

The authors present a 30-year-old pregnant and previously healthy woman with sudden onset of agitation, delusions, and frontal lobe dementia. Serum and cerebrospinal fluid findings revealed the presence of untreated syphilis.

BACKGROUND:

Neurosyphilis can present a variety of behavioral symptoms, including mania, depression, and psychosis.

METHOD:

A neuropsychiatric and neurologic workup was performed before the start of antibiotic treatment. The status of the patient was observed throughout the course of her hospital stay for 7 months. Additionally, a neuropsychological evaluation was administered before treatment, and 2 weeks and 4 months after treatment.

RESULTS:

After treatment of neurosyphilis, steady improvements were noted in psychotic and cognitive symptoms. By the end of 7 months, and after discontinuation of antipsychotic medication, no psychiatric symptoms were evident.

CONCLUSIONS:

This case emphasizes the importance of considering neurosyphilis in the differential diagnosis of acute psychosis. Furthermore, this case shows the dramatic improvement in psychiatric symptoms and cognitive dysfunction in response to the treatment of neurosyphilis.

PMID:
11186166
[PubMed – indexed for MEDLINE]

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