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Syphilis in HIV-infected patients reveals some particular aspects which are clinically relevant and disturbing: it is more frequent and develops more quickly to late stages, namely neurosyphilis; this progression may happen even if classic therapy in the early stages has been undertaken; the diagnosis of neurosyphilis is rather complex, the serological tests being of no definite credit; high doses of intravenous penicillin should be administered for a long period. We report a case that exemplifies the aspects described above.