{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:41:32Z","timestamp":1776080492580,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"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>A case of neurosyphilis with a positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody was reported. A 54-year-old man who presented with acute memory deficits was admitted to our hospital. Acute ischemic stroke (AIS) was initially considered, and he was prescribed intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). However, the intermittent onset of episodic memory and orientation disorder still occurred. No diffusion restriction was indicated by magnetic resonance imaging (MRI), and subclinical seizures were frequently found by electroencephalogram (EEG). Rapid plasma reagin (RPR) test of serum showed positive results for syphilis. Analysis of cerebrospinal fluid (CSF) revealed elevated leukocyte count and protein level. RPR test, <jats:italic>Treponema pallidum<\/jats:italic> particle agglutination (TPPA) assay, and <jats:italic>Treponema pallidum<\/jats:italic> antibody (TP-Ab) in CSF showed positive results, and the anti-NMDAR antibodies were positive in CSF and serum. Finally, the patient was diagnosed with neurosyphilis with a positive anti-NMDAR antibody. The clinical symptoms were improved, and the leukocyte count in CSF was reduced after treatment with intravenous penicillin G and levetiracetam. This case suggests that in cases with positive results for neurosyphilis and NMDAR antibodies, the proper treatment has to be decided based on all of the available clinical and diagnostic testing data.<\/jats:p>","DOI":"10.3389\/fneur.2023.1164605","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T07:20:26Z","timestamp":1684394426000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhu","family":"Sha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gao","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Hongjun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu","family":"Xianzeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,18]]},"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":"912","DOI":"10.1097\/NMD.0b013e31823928e8","article-title":"Neurosyphilis and the spinal cord","volume":"199","author":"Berger","year":"2011","journal-title":"J Nerv Ment Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/S1473-3099(08)70065-3","article-title":"Infectious syphilis in high-income settings in the 21st century","volume":"8","author":"Fenton","year":"2008","journal-title":"Lancet Infect Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"648","DOI":"10.3969\/j.issn.1674-8115.2021.05.015","article-title":"Spatio-temporal analysis of incidence rate of syphilis in China","volume":"41","author":"Tian","year":"2021","journal-title":"J Shanghai Jiaotong Univ."},{"key":"B5","doi-asserted-by":"publisher","first-page":"577753","DOI":"10.1016\/j.jneuroim.2021.577753","article-title":"The changing spectrum of antibody-mediated encephalitis in China","volume":"361","author":"Ren","year":"2021","journal-title":"J Neuroimmunol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/bs.apha.2017.08.005","article-title":"Anti-NMDA receptor encephalitis: clinical features and basic mechanisms","volume":"82","author":"Lynch","year":"2018","journal-title":"Adv Pharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1159\/000079391","article-title":"Current clinical spectrum of neurosyphilis in immunocompetent patients","volume":"52","author":"Conde-Send\u00edn","year":"2004","journal-title":"Eur Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1111\/jdv.16946","article-title":"2020 European guideline on the management of syphilis","volume":"35","author":"Janier","year":"2021","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1056\/NEJMra1906228","article-title":"Neurosyphilis","volume":"381","author":"Ropper","year":"2019","journal-title":"N Engl J Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jgar.2015.12.006","article-title":"A new enhanced antibiotic treatment for early and late syphilis","volume":"5","author":"Drago","year":"2016","journal-title":"J Glob Antimicrob Resist."},{"key":"B11","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.seizure.2008.05.003","article-title":"Symptomatic seizures in neurosyphilis: an experience from a University Hospital in south India","volume":"17","author":"Sinha","year":"2008","journal-title":"Seizure."},{"key":"B12","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/S1474-4422(10)70253-2","article-title":"Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis","volume":"10","author":"Dalmau","year":"2011","journal-title":"Lancet Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1016\/j.autrev.2012.03.001","article-title":"Anti-NMDA receptor encephalitis. 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