Syphilis is a bacterial infection caused by spirochete bacterium treponemapallidum. It is transmitted from one
person to another through direct contact during sexual intercourse. During pregnancy the infection can also pass
from mother to her child. Men who have sex with men are showing fastest rise in syphilis cases. Highest risk
populations are young adults aged between 15 to 25 years. Neurosyphilis can occur anytime during the course of
syphilis, it was rampant in the preantibiotic era whereas in the modern world it is considered a disease of the past
and is rarely seen. However it is resurfacing the medical literature with sporadic cases being reported from all
over the world. Here we are reporting a young male who presented with spasticity and ataxia; on investigation
he had white matter lesions on MRI in the brain and spinal cord. His CSF showed pleocytosis and his blood and
CSF serology was positive for syphilis. The patient later on confirmed sexual contacts in the past hence diagnosis
was confirmed and he responded very well to treatment with nearly complete recovery. It is of prime importance
to consider this disease in neurological differential diagnosis so as to identify this disease as early as possible and
to reduce the mortality risk associated with delayed diagnosis.
Neurosyphilis, Syphilis, Sexually transmitted disease.