{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T12:35:44Z","timestamp":1772886944891,"version":"3.50.1"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Neurosyphilis is an infection caused by the spirochete <jats:italic>Treponema\u00a0pallidum<\/jats:italic>, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as neurosyphilis masquerades with various clinical symptoms and is often missed during initial presentation to the hospital. A comprehensive history and clinical examination are essential to detect suspicious cases early for further cerebrospinal fluid examination and neuroimaging. Patients treated with benzylpenicillin for a specific duration often show promising clinical and cognitive improvement, thus emphasizing the need for constant vigilance in our day-to-day practice.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 77-year-old Caucasian gentleman presented to our hospital repeatedly with multiple episodes of presyncope and cognitive impairment. He also demonstrated bilateral deafness, tabes dorsalis, and left sixth cranial nerve palsy. His cerebrospinal fluid examination showed a nonreactive venereal disease research laboratory test, and magnetic resonance imaging of the brain revealed a gumma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The diagnosis of neurosyphilis in the elderly requires a combination of clinical vigilance and a high index of suspicion, along with multimodal investigations, including cerebrospinal fluid examination and brain imaging.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-03153-1","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:02:27Z","timestamp":1636416147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-520X","authenticated-orcid":false,"given":"Nilesh Anand","family":"Devanand","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3377-6062","authenticated-orcid":false,"given":"Krishnaswamy","family":"Sundararajan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"3153_CR1","unstructured":"Kirby Institute. National update on HIV, viral hepatitis and sexually transmissible infections in Australia: 2009\u20132018. Sydney: Kirby Institute, UNSW Sydney, 2018. https:\/\/kirby.unsw.edu.au\/sites\/default\/files\/kirby\/report\/National-update-on-HIV-viral-hepatitis-and-STIs-2009-2018.pdf."},{"issue":"9","key":"3153_CR2","first-page":"1187","volume":"63","author":"DM Musher","year":"2016","unstructured":"Musher DM. Editorial commentary: polymerase chain reaction for the tpp47 gene: a new test for neurosyphilis. Clin Infect Dis. 2016;63(9):1187\u20138.","journal-title":"Clin Infect Dis"},{"key":"3153_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijid.2018.07.022","volume":"76","author":"A Blazekovic","year":"2018","unstructured":"Blazekovic A, Ozretic D. Neurosyphilis: the shape of a rising threat. Int J Infect Dis. 2018;76:1\u20133.","journal-title":"Int J Infect Dis"},{"key":"3153_CR4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.2147\/IMCRJ.S26281","volume":"5","author":"RP Rodrigues","year":"2012","unstructured":"Rodrigues RP, Correia N, Lopes AV. Neurosyphilis with optical involvement in an immunocompetent patient: a case report. Int Med Case Rep J. 2012;5:5\u201311.","journal-title":"Int Med Case Rep J."},{"issue":"5","key":"3153_CR5","first-page":"433","volume":"86","author":"PL Mattei","year":"2012","unstructured":"Mattei PL, Beachkofsky TM, Gilson RT, Wisco OJ. Syphilis: a reemerging infection. Am Fam Physician. 2012;86(5):433\u201340.","journal-title":"Am Fam Physician"},{"issue":"1","key":"3153_CR6","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1176\/appi.neuropsych.13100303","volume":"27","author":"YQ Zhang","year":"2015","unstructured":"Zhang YQ, Huang M, Jia XY, Zou YF, Chen D. A clinical study of new cases of parenchymal neurosyphilis: has tabes dorsalis disappeared or been missed? J Neuropsychiatry Clin Neurosci. 2015;27(1):17\u201321.","journal-title":"J Neuropsychiatry Clin Neurosci"},{"issue":"12","key":"3153_CR7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1212\/WNL.0000000000003133","volume":"87","author":"RM J\u00fanior","year":"2016","unstructured":"J\u00fanior RM, de Ca\u00e7ador AT, Biasutti C, Gon\u00e7alves GAM, Ferreira J\u00fanior GCU. Teaching neuroimages: skull and dural lesions in neurosyphilis. Neurology. 2016;87(12):129\u201330.","journal-title":"Neurology"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-03153-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-03153-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-03153-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:04:08Z","timestamp":1636416248000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-03153-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3153"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-03153-1","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]},"assertion":[{"value":"26 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our manuscript does not report on an investigational therapy, nor does it involve the use of any animal or human data or tissue in any experiment; hence, this section related to ethics approval does not apply to our submission. Ethics committee approval to produce a case report in the presence of written consent from the patient was, therefore, deemed inapplicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Both authors declares no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"552"}}