{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:56:19Z","timestamp":1790636179634,"version":"4.1.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Neurosyphilis (NS) is an infection of the central nervous system caused by Treponema pallidum. It mimics various neurological and psychiatric diseases. In recent years, there have been several NS cases that manifest as limbic encephalitis (LE). Therefore, the diagnosis of neurosyphilis in the early stages is difficult. Here, we present a case of an NS patient who presented with LE manifestation. The 62-year-old woman presented with acute clinical manifestations of gibberish speech, poor memory, and seizures. Brain MRI showed abnormal signals on the right medial temporal lobe. In addition, the patient had a positive serum leucine-rich glioma inactivated 1 (LGI1) antibody with a titer of 1:16. Therefore, an initial diagnosis of anti-LGI1 encephalitis was made. However, further tests carried out showed positive rapid plasma reagin (RPR), and treponema pallidum particle agglutination (TPPA) tests both in the serum and the cerebrospinal fluid (CSF). Therefore, uncertainty arose as to whether the patient had both anti-LGI1 encephalitis and NS or whether the LGI1 antibody and LE manifestations were due to the NS. The patient was initiated on the recommended dose of penicillin G sodium. Following treatment, the patient reported a significant improvement in clinical symptoms, normal signals in the right temporal lobe, and a negative serum LGI1 antibody. These findings suggested that NS induced the LE manifestations and the production of the LGI1 antibody. This case demonstrates that testing syphilis in patients with LE is important and positive autoimmune encephalitis (AE) antibodies in NS patients need to be viewed and interpreted with greater caution.<\/jats:p>","DOI":"10.3389\/fneur.2022.862175","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T05:20:36Z","timestamp":1652332836000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Case Report: A Case Report of Neurosyphilis Mimicking Limbic Encephalitis"],"prefix":"10.3389","volume":"13","author":[{"given":"Haibing","family":"Liao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/B978-0-444-63849-6.00012-8","article-title":"Other central nervous system infections: cytomegalovirus, mycobacterium tuberculosis, and treponema pallidum","volume":"152","author":"Marra","year":"2018","journal-title":"Handb Clin Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1097\/OLQ.0000000000000768","article-title":"rapid increase in reports of syphilis associated with men 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MMWR Recomm Rep642015"},{"key":"B14","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1086\/591534","article-title":"Normalization of serum rapid plasma reagin titer predicts normalization of cerebrospinal fluid and clinical abnormalities after treatment of neurosyphilis","volume":"47","author":"Marra","year":"2008","journal-title":"Clin Infect Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1111\/ijd.12865","article-title":"Neurosyphilis and brain magnetic resonance imaging","volume":"54","author":"Czarnowska-Cuba\u0142a","year":"2015","journal-title":"Int J Dermatol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1097\/PRA.0000000000000390","article-title":"A case report of neurosyphilis limbic encephalitis with reversible geschwind syndrome and mood disorder","volume":"25","author":"Toffanin","year":"2019","journal-title":"J Psychiatr Pract."},{"key":"B17","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.neurol.2020.04.021","article-title":"All that glitters is not gold: a limbic encephalitis due to neurosyphilis","volume":"177","author":"Pisch\u00e9","year":"2021","journal-title":"Rev Neurol (Paris)."},{"key":"B18","doi-asserted-by":"publisher","first-page":"E962","DOI":"10.1503\/cmaj.170190","article-title":"Neurosyphilis mimicking autoimmune encephalitis in a 52-year-old man","volume":"189","author":"Budhram","year":"2017","journal-title":"CMAJ."},{"key":"B19","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1002\/ana.23689","article-title":"N-methyl-D-aspartate receptor antibodies in herpes simplex encephalitis","volume":"72","author":"Pr\u00fcss","year":"2012","journal-title":"Ann Neurol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s00415-005-0941-6","article-title":"Incidence and pathogenesis of clinical relapse after herpes simplex encephalitis 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