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Open Access

Syphilitic encephalitis - a rare disease and a possible differential diagnosis of herpetic encephalitis

  • Mihaela Ionică1Email author,
  • Magdalena Vasile1,
  • Șerban Benea1,
  • Virgil Ionescu1 and
  • Elisabeta Benea1
BMC Infectious Diseases201414(Suppl 7):P97

Published: 15 October 2014


Herpes SimplexEncephalitisVirus EncephalitisPsychiatric UnitLentiform Nucleus


Syphilitic encephalitis is an atypical presentation form of central neural system infection by Treponema pallidum. There are only few case-reports in medical literature.

Case report

We present the case of a 41 year-old male, diagnosed with syphilitic encephalitis, in whom cerebral magnetic resonance imaging demonstrated preponderant involvement of bilateral temporal lobes, for this point of view raising differential diagnostic concerns with Herpes virus encephalitis. We also identified multiple encephalitis foci: hippocampus, lentiform nucleus, left thalamus, left midbrain, and bilateral occipital. The detection of herpes simplex virus DNA by PCR in CSF obtained at admission was negative. Furthermore, the subacute onset as a maniacal syndrome delayed the diagnostic, the patient being initially treated as psychiatric disorder in a Psychiatric Unit.


Although the clinical and imagistic evolution was favorable under specific optimal therapy, the patient had some neuropsychiatric sequels and is currently enrolled in a medical recovery treatment.


Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Authors’ Affiliations

National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania


© Ionică et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.