HIV-complicated meningovascular syphilis: Atypical symptoms with promising result using low molecular weight heparin

William C. W. Huang, Chia-Huei Chiu

Department of Family Medicine, Show-Chuan Memorial Hospital, Changhua, China.
Office of Medical Administration, Taichung Veterans’ General Hospital, Taizhong, China.

DOI: 10.4236/wjns.2012.24029                

Abstract

Both WHO and the CDC of Taiwan have reports indicating a dramatic increase in incidence of both syphilis and HIV. With their co-infection, neurosyphilis will become a major issue, and meningovascular insults may become more complex to these Sexually Transmitted Diseases (STD). We are reporting a young individual presented with quadriparesis and initial National Institutes of Health Stroke Scale (NIHSS) greater than 20 points after having flu-like symptoms and diarrhea for a couple of days. The patient was later diagnosed as HIV-complicated meningovascular syphilis by positive blood and CSF laboratory tests. After seven-days of low molecular weight heparin (LMWH) treatment, the patient improved dramatically with NIHSS score of 2 before being transferred to HIV center for further treatment. In contrary, there is case report that demonstrates mortality after treated meningovascular syphilis with rtPA and recanalization. As the world faltten and population of HIV spreads worldwide, the prevalence of stroke in young people may increase in the upcoming century. Only scattered case reports have been presented worldwide discussing the treatment of HIV complicated with meningovascular syphilis. We are the first to rescue the stroke in the patient of HIV with syphilis by LMWH. This case report may contribute to a better treatment for infectious patient with stroke.

Keywords

Meningovascular Syphilis; HIV

Conflicts of Interest

The authors declare no conflicts of interest.

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