초록
후천성 면역 결핍증 환자에서 신경매독이 발생할 확률은 정상인에 비해 높으며, 임상 증상은 다양하게 나타날 수 있다. 후천성 면역 결핍증을 가진 42세 남자가 급성 뇌경색 형태의 신경 매독 증상을 보였으며 이에 대해 항 혈소판 치료, 항생제 치료, 항 바이러스 치료를 함께 시행하였고, 성공적으로 치료하였기에 증례로 보고하는 바이다.
While the neurologic manifestations of syphilis are diverse, stroke is a rare initial manifestation. We report a human immunodeficiency virus (HIV)-positive patient whose neurosyphilis presented as a stroke. A 42-year-old male visited the emergency room due to decreased mental functioning. Brain magnetic resonance imaging showed acute infarct on the left frontal, temporal, and parietal lobes. A serum Venereal Disease Research Laboratory (VDRL) test was positive. ELISA for HIV antibody and Western blot assays revealed he was infected with HIV. The cerebrospinal fluid (CSF) VDRL test was positive and protein was increased. The patient was treated with heparization and penicillin G for 14 days. His mental status improved with treatment, and CSF protein and VDRL titers were also decreased 3 months after treatment.