Ischemic Stroke as the Initial Manifestation of Neurosyphilis in a Young Adult Patient Positive for Human Immunodeficiency Virus

A 31-year-old man with pontine infarction was referred to our hospital for further evaluation and treatment. At admission, his neurological examination was unremarkable. No lymphadenopathy or skin lesions were found. The Treponema pallidum haemagglutination test, rapid plasma regain test and fluorescent treponemal antibody absorption test of immunoglobulin G were positive in both serum and cerebrospinal fluid (CSF). CSF analysis showed lymphocytic pleocytosis. The patient had male-to-male sexual contact and was found to be HIV positive. Physicians should be aware that acute ischaemic stroke may be the first manifestation of neurosyphilis in a young adult, especially with HIV infection.

The Herculaneum Graffiti Project: Initial Field Season, 2014

This article describes the goals and activities for the first field season of The Herculaneum Graffiti Project. Our project fo-cuses on documenting and digitizing to make more broadly accessible the first-century handwritten wall-inscriptions, also called graffiti, in Herculaneum. Following an overview of the presence of ancient graffiti in Herculaneum, this report details the methodology we used to locate and document the inscriptions and the preservation status of ancient graffiti in each insula, or city-block, of the excavations. We further describe the preliminary results of the project’s documentation efforts. We are currently studying, processing, and digitizing these inscriptions and contributing them for inclusion in the Epigraphic Database Roma and EAGLE, the Europeana network of Ancient Greek and Latin Epigraphy. We conclude with a brief mention of development of The Ancient Graffiti Project, the digital resource and search engine devoted to ancient handwritten inscriptions.

Acute Q Fever Presenting with Multi-Organ Failure: Re-Evaluation of the Initial Diagnosis

We present the case of a 48-year-old man admitted to the critical care unit with atrial fibrillation, and acute heart and kidney failure accompanied by coagulopathy and an abnormal liver test. Initially diagnosed as a non-ST elevation myocardial infarction, re-evaluation of the case led to the consideration of severe sepsis. Q fever and leptospirosis were the most probable causes and empiric treatment was initiated. A complete recovery was achieved following treatment.