[Atypical neurosyphilis: report of a case].

The present study is based on the observation of a case at the inpatient service of Clinica Olivé Leite in August 1992. A 31 years old female patient, showing cognitive deterioration and dementia syndrome associated with paranoid elements (hallucination and delirium), was admitted as a case of organic psychosis. Diagnostic investigation evidenced positive tests for syphilis in serum and cerebrospinal fluid. The following peculiar aspects are emphasized in this case: severe clinical presentation, severe presentation symptoms (amaurosis and a severe cognitive deficit), sex, age, and for being the first case diagnosed in the service since 1968 (occasion in which the last neurosyphilis case was registered in its data bank). In the following nine months, after penicillin therapy, the patient showed some improvement characterized by a reduction of productive symptoms of hallucination and delusion type, reduction of the cognitive deficit, and a higher production of the social behavior activities.