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Neurosyphilis masquerading as autoimmune encephalitis
  1. Davi Teixeira Urzêdo Queiroz1,
  2. Jéssica de Cássia Marques Leocádio1,
  3. Laura Helena Poggianella Esteves Santana1,
  4. Carolina Sales Carlos1,
  5. João Victor Lage Guerra1,
  6. Pétala Silva Ribeiro1,
  7. Eda Maria Faleiros Cardoso Nunes2,
  8. Arthur de Alvarenga Mafra Batista3,
  9. Bruno da Silva Guimarães3,
  10. Fabrício Manoel Rezende Dias2,
  11. Galileu Chagas Lourenço1,
  12. Lucas Bruno Rezende1
  1. 1 Neurology, Vila da Serra Hospital, Nova Lima, Brazil
  2. 2 Critical Care, Vila da Serra Hospital, Nova Lima, Brazil
  3. 3 Internal Medicine, Vila da Serra Hospital, Nova Lima, Brazil
  1. Correspondence to Dr Lucas Bruno Rezende, Neurology, Hospital Vila da Serra, Nova Lima, MG 34000-000, Brazil; lucasbrunorezende{at}hotmail.com

https://doi.org/10.1136/pn-2023-003943

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    A 34-year-old man required intensive care unit admission for recurrent seizures. He had a 1-year history of unexplained psychiatric illness, with depression, catatonia, cognitive decline, psychosis and persecutory delusions, unresponsive to antipsychotics and antidepressants.

    His MR scan of brain suggested autoimmune encephalitis1 (figures 1–3). Electroencephalogram (figure 4) identified non-convulsive status epilepticus. Cerebrospinal fluid (CSF) analysis was inflammatory, with a white cell count of 2 x 109/L (≤5), protein 1.02 g/L (0.15–0.45) and glucose 5.0 mmol/L (plasma 5.6). Serum treponemal and Venereal Disease Research Laboratory (VDRL) tests were positive, with VDRL titres in serum of 1:16 and in CSF of 1:32. Serologies for HIV and other sexually transmitted diseases were negative. Malignancy screening was negative, including …

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    Footnotes

    • Contributors 1. Manuscript preparation: A. Writing of the first draft. B. Review and critique. DTUQ and LBR: 1A; JdCML, LHPES, CSC, JVLG, PSR, EMFCN, AdAMB, BdSG, FMRD and GCL: 1B.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned. Externally peer reviewed by Mark Willis, Cardiff, UK.