Open Access Highly Accessed Case report

Neurosyphilis manifesting with unilateral visual loss and hyponatremia: a case report

Katrin Milger1*, Vera Fleig1, Anke Kohlenberg2, Thomas Discher1 and Jürgen Lohmeyer1

Author Affiliations

1 Department of Internal Medicine II, Justus-Liebig University Giessen, Klinikstr. 36, 35392 Giessen, Germany

2 Department of Medical Microbiology, Justus-Liebig University Giessen, Frankfurterstr. 107, 35392 Giessen, Germany

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BMC Infectious Diseases 2011, 11:17  doi:10.1186/1471-2334-11-17

Published: 15 January 2011



Syphilis is called the chameleon of the diseases due to its variety of its clinical presentations, potentially affecting every organ of the body. Incidence of this ancient disease is once again on the increase worldwide.

Case presentation

We here report an unusual case of neurosyphilis manifesting with unilateral visual loss and hyponatremia. The patient also had primary syphilitic lesions and was concomitantly diagnosed with Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Treatment with ceftriaxone and prednisolone, completely resolved the hyponatremia and visual acuity was partially restored.


Awareness of syphilis as a differential diagnosis is important as previously unreported presentations of neurosyphilis can arise, especially in HIV infected patients.