Ischemic stroke as a presenting feature of neurosyphilis in an immunocompetent adult and attained complete recovery following treatment: a case report and review of the literature.

backgroundNeurosyphilis typically presents with nonspecific symptoms such as behavioral changes or cognitive impairment, rather than an initial stroke. CASE PRESENTATION: This case report describes a Black African man in his thirties who experienced sudden weakness on the left side of his body. Computed tomography suggested a nucleo-capsular ischemic lesion. However, given his young age and lack of traditional stroke risk factors, further investigations were pursued. Laboratory tests revealed positive results for syphilis in both blood and cerebrospinal fluid. Additional imaging (head and neck angiography) indicated intracranial vasculitis with widespread and acute ischemia in the right hemisphere. Treatment with ceftriaxone and aspirin was initiated. Through ongoing monitoring and care, the patient's neurological condition improved.

conclusionThe case underscores the critical need for prompt diagnosis and comprehensive assessment in patients experiencing stroke-like symptoms, especially in younger individuals. By recognizing neurosyphilis as a potential cause, healthcare providers can initiate timely treatment and improve patient outcomes.