Multiple cerebral syphilitic gummas mimicking brain tumor in a non-HIV-infected patient: A case report |
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Authors: | Ryota Sasaki Natsuki Tanaka Tomoko Okazaki Taiji Yonezawa |
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Institution: | 1. Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan;2. Department of Neurology, Osaka Police Hospital, Osaka, Japan |
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Abstract: | We present a unique case of symptomatic early neurosyphilis in a non-HIV-infected patient. A 47-year-old man with a history of diabetes mellitus presented with generalized seizures. He did not manifest any neurological deficits. At first, multiple brain tumors were suspected based on findings from magnetic resonance imaging of the brain. However, serological and cerebrospinal fluid tests for syphilis yielded positive results, and the masses were reduced using amoxicillin. Multiple cerebral syphilitic gummas were therefore diagnosed. High-dose penicillin therapy was initiated and syphilitic gummas disappeared after five months. Treponema pallidum could invade the central nervous system at an early phase, and sometimes may be difficult to distinguish from malignant brain tumor. If intracranial lesions are identified in a syphilis-infected patient, cerebral syphilitic gumma should be considered as a differential diagnosis. |
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Keywords: | Neurosyphilis Multiple cerebral syphilitic gummas Human immunodeficiency virus |
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