Left temporal cerebral syphilitic gumma: Case report and literature review

Barahona, E. Ariñez; Olvera, Juan; Liquidano, Mauricio Armando Esqueda; Cobos, A. Muñoz; Arroyo, Álvaro; Apo, Erick Gómez

doi:10.1016/j.hgmx.2016.04.008

Cited by 4 publications

(6 citation statements)

References 17 publications

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“…As with other mass lesions, the clinical manifestations will depend on the size and location of the gumma. 3 Radiologically, MRI generally demonstrates hypointensity on T1WI and hyperintensity on T2WI with adjacent edema, associated with ringlike, strip-like, or uniform enhancements on gadoliniumenhanced T1WI. 4 The Jarisch-Herxheimer reaction (JHR) is an acute, selflimiting inflammatory condition, occurring in approximately 10-35% of cases within 24 hours of initiating antibiotic therapy in patients infected by spirochetes.…”

Section: Discussionmentioning

confidence: 99%

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Gummatous Neurosyphilis With Transient Worsening of Neurological Symptoms After Treatment Initiation

Hutchinson

Shnawa

Lerner

et al. 2023

The Neurohospitalist

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Cerebral syphilitic gumma is an atypical presentation of neurosyphilis, the clinical manifestations of which depend on the size and location of the lesions. It radiologically presents as enhancing nodular lesion(s) in brain parenchyma. We present a case of a patient with cerebral syphilitic gummas who had worsening neurological symptoms a few hours after initiation of anti-syphilitic antibiotic treatment. We aim to illustrate the clinical and radiological characteristics that might be helpful to clinicians when approaching the challenges they might encounter while treating neurosyphilis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gummatous Neurosyphilis With Transient Worsening of Neurological Symptoms After Treatment Initiation

Hutchinson

Shnawa

Lerner

et al. 2023

The Neurohospitalist

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“…Six months later, the patient developed a new cerebral gumma lesion. [3] A follow-up lumbar puncture should be performed every 6 months until the CSF cell count is normal. CSF VDRL and protein levels can also be monitored, although these levels tend to normalize at a slower rate than the cell count.…”

Section: Discussionmentioning

confidence: 99%

“…Studies show that gummatous neurosyphilis is the rarest form of the various types. [1,2] And a literature search from 1980 to 2017 revealed the majority of CNS syphilitic gummas to be single, [3–8] with a minority consisting of multiple lesions. [9,10] Multiple syphilitic gummas involving both the brain and spinal cord are quite rare.…”

Section: Introductionmentioning

confidence: 99%

“…CNS syphilitic gummas are commonly misdiagnosed as brain tumors, resulting in surgery. [3–8] Standard penicillin therapy accompanied by magnetic resonance imaging (MRI) findings of a decrease in mass size is useful for the diagnosis of CNS syphilitic gummas in cases where neurosyphilis can be diagnosed based on cerebrospinal fluid (CSF) examination, thereby avoiding unnecessary surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Multiple intracranial and spinal cord syphilitic gummas in a human immunodeficiency virus-negative man with untreated syphilis

et al. 2019

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Rationale:Multiple syphilitic gummas involving both the brain and spinal cord are quite rare. Central nervous system (CNS) syphilitic gummas are commonly misdiagnosed as CNS tumors, and clinical suspicion and diagnosis of a syphilitic gumma by physicians are vital to avoiding unnecessary surgeries. Our case emphasizes the importance of routine serologic syphilis tests and standard therapy with penicillin in patients with a CNS mass.Patient concerns:A 22-year-old previously healthy man presented with a 9-day history of progressive right lower limb weakness.Diagnosis:The diagnosis of gummatous neurosyphilis was based on positive serological, cerebrospinal fluid tests for syphilis and magnetic resonance imaging (MRI) findings, which revealed the presence of multiple dural-based enhancing masses with marked edema.Interventions:Therapy consisting of intravenous penicillin G at 24 million units daily divided into 6 doses were given for a total of 21 days, along with 3 weekly intramuscular injections of benzathine penicillin G (2.4 million units) to ensure that the syphilitic lesions in the CNS were adequately treated.Outcomes:Complete resolution of the lesions was observed on MRI over a 3-month period.Lessons:The importance of routine serologic syphilis tests and standard therapy with penicillin in patients with central CNS mass lesions is noted to avoiding unnecessary surgeries.

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