{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T13:26:12Z","timestamp":1794317172102,"version":"4.9.0"},"reference-count":19,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:p>Neurosyphilis is a central nervous system (CNS) infection that has become exceedingly rare in the postantibiotic era, especially in children and HIV-negative persons. It can develop during any stage of an untreated syphilis infection and is known as \u201cthe great imitator\u201d for its highly variable clinical presentation with inconsistent lab and imaging findings. We describe the case of a previously healthy 17-year-old boy who presented with 2\u00a0weeks of right thumb and middle finger myoclonus followed by right upper extremity focal seizures with secondary generalization. Routine and confidential psychosocial history using the HEADSS (Home; Education, Eating, and Exercise; Activities; Drugs; Sexuality; Suicide and Sleep) assessment revealed that our patient was sexually active with one female partner, prompting sexually transmitted infection (STI) screening. The final diagnosis of neurosyphilis was made following a reactive rapid plasma reagin screen and confirmatory treponemal testing of the cerebrospinal fluid. In light of the recent rise in syphilis case incidence and the devastating consequences of CNS involvement, neurosyphilis should be considered in the differential diagnoses for all sexually active adolescents with unexplained neurologic symptoms. Additionally, this case highlights the importance of comprehensive and confidential social history taking in all adolescents, as well as regular STI screening for those at risk.<\/jats:p>","DOI":"10.1542\/peds.2026-076004","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:02:11Z","timestamp":1791936131000},"source":"Crossref","is-referenced-by-count":0,"title":["An Adolescent With Neurosyphilis"],"prefix":"10.1542","volume":"158","author":[{"given":"Danielle","family":"Owerko","sequence":"first","affiliation":[{"name":"1Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"2Children\u2019s Wisconsin, Milwaukee, Wisconsin"},{"name":"3Current affiliation: University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Burek","sequence":"additional","affiliation":[{"name":"1Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"2Children\u2019s Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Watson","sequence":"additional","affiliation":[{"name":"1Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"2Children\u2019s Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"4","key":"2026111007565109600_r1","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1212\/CON.0000000000000982","article-title":"Neurosyphilis","volume":"27","author":"Chow","year":"2021","journal-title":"Continuum (Minneap Minn)."},{"issue":"5","key":"2026111007565109600_r2","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1002\/ana.78016","article-title":"Neurosyphilis","volume":"98","author":"Minter","year":"2025","journal-title":"Ann Neurol."},{"issue":"5","key":"2026111007565109600_r3","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1093\/cid\/ciad437","article-title":"State-of-the-Art Review: Neurosyphilis","volume":"78","author":"Hamill","year":"2024","journal-title":"Clin Infect Dis."},{"issue":"14","key":"2026111007565109600_r4","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1056\/NEJMra1906228","article-title":"Neurosyphilis","volume":"381","author":"Ropper","year":"2019","journal-title":"N Engl J Med."},{"key":"2026111007565109600_r5","article-title":"Sexually Transmitted Disease Surveillance","author":"Centers for Disease Control and Prevention","year":"2001"},{"key":"2026111007565109600_r6","volume-title":"Sexually Transmitted Infections Surveillance 2022","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"2026111007565109600_r7","volume-title":"Sexually Transmitted Infections Surveillance 2023","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"2026111007565109600_r8","article-title":"Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources","author":"Centers for Disease Control and Prevention","year":"2025"},{"issue":"1","key":"2026111007565109600_r9","doi-asserted-by":"crossref","first-page":"e003000","DOI":"10.1136\/bmjoq-2024-003000","article-title":"Improving compliance with conducting HEADSS biopsychosocial assessment for adolescents in a paediatric inpatient setting","volume":"14","author":"Tan","year":"2025","journal-title":"BMJ Open Qual."},{"issue":"4","key":"2026111007565109600_r10","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3390\/neurosci2040031","article-title":"Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review","volume":"2","author":"Giovannini","year":"2021","journal-title":"NeuroSci."},{"key":"2026111007565109600_r11","first-page":"647","article-title":"Neurosyphilis Presenting as Psychiatric Symptoms at Younger Age: A Case Report","volume":"17","author":"Li","year":"2024","journal-title":"Int Med Case Rep J."},{"issue":"5","key":"2026111007565109600_r12","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jemermed.2018.01.043","article-title":"Neurosyphilis as a Cause of Transverse Myelitis in a Teenage Girl","volume":"54","author":"Jo Yaphockun","year":"2018","journal-title":"J Emerg Med."},{"issue":"8","key":"2026111007565109600_r13","doi-asserted-by":"crossref","first-page":"140","DOI":"10.15585\/mmwr.mm7408a3","article-title":"Notes from the Field: Neurosyphilis, Ocular Syphilis, and Otic Syphilis - Chicago, January-October 2023","volume":"74","author":"Nham","year":"2025","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"2","key":"2026111007565109600_r14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.neurad.2023.01.003","article-title":"Imaging features of neurosyphilis","volume":"50","author":"Corr\u00eaa","year":"2023","journal-title":"J Neuroradiol."},{"issue":"3","key":"2026111007565109600_r15","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00234-021-02827-3","article-title":"Neurosyphilis in disguise","volume":"64","author":"Jum\u2019ah","year":"2022","journal-title":"Neuroradiology."},{"issue":"5","key":"2026111007565109600_r16","doi-asserted-by":"crossref","first-page":"e20172858","DOI":"10.1542\/peds.2017-2858","article-title":"Sexual and Reproductive Health Care Services in the Pediatric Setting","volume":"140","author":"Marcell","year":"2017","journal-title":"Pediatrics."},{"issue":"5","key":"2026111007565109600_r17","doi-asserted-by":"crossref","first-page":"e20200627","DOI":"10.1542\/peds.2020-0627","article-title":"Emerging Issues in Male Adolescent Sexual and Reproductive Health Care","volume":"145","author":"Grubb","year":"2020","journal-title":"Pediatrics."},{"issue":"7","key":"2026111007565109600_r18","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1542\/hpeds.2022-006955","article-title":"Quality Improvement: A Template-Based Approach to HEADSS Assessments for Hospitalized Adolescents","volume":"13","author":"Wiley","year":"2023","journal-title":"Hosp Pediatr."},{"key":"2026111007565109600_r19","volume-title":"Sexually Transmitted Infections: Adopting a Sexual Health Paradigm","year":"2021"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2026-076004\/1977327\/pediatrics.2026076004.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2026-076004\/1977327\/pediatrics.2026076004.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:56:58Z","timestamp":1794315418000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/158\/5\/e2026076004\/210920\/An-Adolescent-With-Neurosyphilis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":19,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10,14]]},"published-print":{"date-parts":[[2026,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2026-076004","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"article-number":"e2026076004"}}