Meningovascular neurosyphilis presenting as multifocal stroke in an HIV patient on ART: a diagnostic challenge in a resource-limited setting: case report and literature review

Clinicians should maintain suspicion for meningovascular neurosyphilis in HIV-positive patients presenting with stroke-like deficits regardless of virologic suppression or absence of conventional vascular risk factors. MRI and CSF evaluation are crucial where diagnostic uncertainty persists, and ceftriaxone is an effective alternative when penicillin cannot be accessed. Despite significant neurological recovery, management conclusions cannot be generalized from a single case.