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BMJ Case Reports 2011; doi:10.1136/bcr.09.2011.4813
  • Reminder of important clinical lesson

Syphilis mimicking idiopathic intracranial hypertension

  1. Rigmor Jensen1
  1. 1Neurology Department, Glostrup University Hospital, Glostrup, Denmark
  2. 2Opththalmology Department, Glostrup University Hospital, Glostrup, Denmark
  1. Correspondence to Mrs Hanne Yri, hamayr01{at}glo.regionh.dk

Summary

Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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