{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:09:59Z","timestamp":1791216599263,"version":"4.1.0"},"reference-count":12,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,29]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>A man in his 50s presented with focal seizures and was found to have an inflammatory cerebrospinal fluid (CSF) with bilateral mesiotemporal lobe hyperintensity on magnetic resonance imaging (MRI) of the brain. Corticosteroid treatment was initiated for management of limbic encephalitis. Focal seizures, imaging abnormalities and inflammatory CSF persisted despite treatment and the patient was found to have neurosyphilis after developing neuropsychiatric symptoms. Syphilis is a sexually transmitted bacterial infection with multisystem involvement including neurological and psychiatric manifestations. Case reports have emerged of neurosyphilis presenting as limbic encephalitis with CSF pleocytosis and temporal lobe hyperintensity on MRI of the brain. Persistence of CSF or MRI abnormalities despite immunosuppressive therapy for limbic encephalitis should prompt investigation for alternate causes of chronic meningoencephalitis, which can occasionally include neurosyphilis.<\/jats:p>","DOI":"10.1136\/bcr-2023-258794","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T10:25:16Z","timestamp":1702549516000},"page":"e258794","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Neurosyphilis presenting as limbic encephalitis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2345-2806","authenticated-orcid":false,"given":"Matthew","family":"Shrimpton","sequence":"first","affiliation":[{"name":"Neurology Department, Barwon Health, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Neurology Department, Barwon Health, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"2025082712495729000_16.12.e258794.1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.mi.35.100181.000333"},{"key":"2025082712495729000_16.12.e258794.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1906228"},{"key":"2025082712495729000_16.12.e258794.3","first-page":"1492","article-title":"Update","volume":"27","year":"2021","journal-title":"Continuum (Minneap Minn)"},{"key":"2025082712495729000_16.12.e258794.4","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1111\/imj.15691","article-title":"Neurosyphilis in the Northern Territory of Australia: a clinical guideline","volume":"53","author":"Birrell","year":"2023","journal-title":"Intern Med J"},{"key":"2025082712495729000_16.12.e258794.5","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-823493-8.00024-9"},{"key":"2025082712495729000_16.12.e258794.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2007.12.003"},{"key":"2025082712495729000_16.12.e258794.7","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000087"},{"key":"2025082712495729000_16.12.e258794.8","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-325300"},{"key":"2025082712495729000_16.12.e258794.9","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/j.clineuro.2012.11.012","article-title":"Auto-antibody-negative limbic-like encephalitis as the first manifestation of neurosyphilis","volume":"115","author":"Geisler","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"key":"2025082712495729000_16.12.e258794.10","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2022.862175","article-title":"Case report: a case report of neurosyphilis mimicking limbic encephalitis","volume":"13","author":"Liao","year":"2022","journal-title":"Front Neurol"},{"key":"2025082712495729000_16.12.e258794.11","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10072-017-3109-0","article-title":"Mesial encephalitis: an uncommon presentation of neurosyphilis: a case report and review of the literature","volume":"39","author":"Serrano-Cardenas","year":"2018","journal-title":"Neurol Sci"},{"key":"2025082712495729000_16.12.e258794.12","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000030062","article-title":"Neurosyphilis presenting as autoimmune limbic encephalitis: a case report and literature review","volume":"101","author":"Mizoguchi","year":"2022","journal-title":"Medicine (Baltimore)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258794","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:50:03Z","timestamp":1756324203000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":12,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12,14]]},"published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1136\/bcr-2023-258794"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258794","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]}}}