Neurosyphilis : About Four Cases Hospitalized at the Ibn Rochd University Hospital in Casablanca

Neurosyphilis remains a complex diagnostic entity due to the wide variability of its clinical manifestations and the frequency of normal brain imaging, particularly in the early stages of the disease. Despite therapeutic and diagnostic advances, it remains a public health problem in the context of a global resurgence of syphilis. We report a series of four cases of neurosyphilis hospitalized at the Ibn Rochd University Hospital in Casablanca between 2024 and 2025. The patients were between 34 and 48 years old, including one patient recently diagnosed with HIV and three immunocompetent patients. All presented with neurological manifestations dominated by persistent headaches, with a completely normal brain CT scan. Serological tests showed positivity for TPHA and VDRL in serum and cerebrospinal fluid, confirming the diagnosis. The outcome under treatment with intravenous penicillin G was favorable in all patients. This case series highlights the importance of considering neurosyphilis in any case of unexplained neurological symptoms, including in immunocompetent patients and in the absence of radiological abnormalities.