Syphilitic Meningomyelitis Treated with Ceftriaxone: Case Report

Although neurosyphilis is often referred to as a tertiary or late stage or-syphilitic infection, involvement of the CNS may occur at any point during the course of the infection. Other than doxycycline, which penetrates the CNS, there are few therapeutic alternatives to penicillin for the treatment of neurosyphilis. We describe a patient with secondary syphilis and meningomyelitis who responded to treatment with ceftriaxone. A 37-year-old, HIV-negative male presented in February 1992 with a 2-week history of progressive weakness of his lower extremities, paresthesia and numbness of both thighs, increased urinary frequency, and impotence. His history included an accelerated allergic reaction to penicillin (wheezing) in 1989, a negative VDRL (Venereal Disease Research Laboratories) test in 1982, and sexual contact with a prostitute in 1991.