Tabes dorsalis – a disease that must not be forgotten

Introduction
The central nervous system can be invaded by Treponema pallidum at any stage of syphilis.

Objective
To present a case of tabes dorsalis, which developed in a patient with undiagnosed and untreated syphilis.

Case report
A 56-year-old woman was admitted because of positive serological tests for syphilis. The serological tests for syphilis titers in the patient’s serum were: VDRL – 1/128, FTA – 1/36 000, FTA-ABS (+), TPHA – 1/81 920. Neurological and ophthalmic abnormalities were found. The VDRL test was negative and treponemal tests were positive in cerebrospinal fluid. Pleocytosis was normal. On the basis of history, clinical abnormalities and serological tests for syphilis, the diagnosis of tabes dorsalis was made. Treatment according to the European guidelines was administered. Six months later titers of serological tests for syphilis remained stable. Neurological abnormalities were partially reversed.

Conclusions
A lack of public mass screening for syphilis contributes to the presence of cases of late syphilis, including late neurosyphilis.