Browse > Article
http://dx.doi.org/10.3340/jkns.2013.53.3.197

Cerebral Syphilitic Gumma Mimicking a Brain Tumor in the Relapse of Secondary Syphilis in a Human Immunodeficiency Virus-Negative Patient  

Yoon, Young Kyung (Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine)
Kim, Min Ja (Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine)
Chae, Yang Seok (Division of Infectious Diseases, Department of Pathology, Korea University College of Medicine)
Kang, Shin-Hyuk (Division of Infectious Diseases, Department of Neurosurgery, Korea University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.53, no.3, 2013 , pp. 197-200 More about this Journal
Abstract
Diagnosis of cerebral syphilitic gumma is frequently determined at the time of surgery, because imaging and laboratory findings demonstrate the elusive results. A 59-year-old woman presenting dysarthria showed a mass on her brain computed tomography. She was first suspected of brain tumor, but histological results from surgical resection revealed cerebral gumma due to neurosyphilis. After operation, she presented fever and rash with an infiltration on a chest X-ray. Histological assessment of skin was consistent with syphilis. Fluorescent treponemal antibody absorbed test IgG in cerebrospinal fluid was positive. She was successfully treated with ceftriaxone for 14 days.
Keywords
Gummatous neurosyphilis; Latent syphilis; HIV negative; Ceftriaxone;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Clark EG, Danbolt N : The Oslo study of the natural history of untreated syphilis; an epidemiologic investigation based on a restudy of the Boeck-Bruusgaard material; a review and appraisal. J Chronic Dis 2 : 311-344, 1955   DOI
2 Ances BM, Danish SF, Kolson DL, Judy KD, Liebeskind DS : Cerebral gumma mimicking glioblastoma multiforme. Neurocrit Care 2 : 300-302, 2005   DOI
3 Berger JR, Waskin H, Pall L, Hensley G, Ihmedian I, Post MJ : Syphilitic cerebral gumma with HIV infection. Neurology 42 : 1282-1287, 1992   DOI
4 Brightbill TC, Ihmeidan IH, Post MJ, Berger JR, Katz DA : Neurosyphilis in HIV-positive and HIV-negative patients : neuroimaging findings. AJNR Am J Neuroradiol 16 : 703-711, 1995
5 Cnossen WM, Niekus H, Nielsen O, Vegt M, Blansjaar BA : Ceftriaxone treatment of penicillin resistant neurosyphilis in alcoholic patients. J Neurol Neurosurg Psychiatry 59 : 194-195, 1995   DOI
6 Coleman DL, McPhee SJ, Ross TF, Naughton JL : Secondary syphilis with pulmonary involvement. West J Med 138 : 875-878, 1983
7 Holland BA, Perrett LV, Mills CM : Meningovascular syphilis : CT and MR findings. Radiology 158 : 439-442, 1986   DOI
8 Darwish BS, Fowler A, Ong M, Swaminothan A, Abraszko R : Intracranial syphilitic gumma resembling malignant brain tumour. J Clin Neurosci 15 : 308-310, 2008   DOI
9 Fargen KM, Alvernia JE, Lin CS, Melgar M : Cerebral syphilitic gummata : a case presentation and analysis of 156 reported cases. Neurosurgery 64 : 568-575; discussioin 575-576, 2009   DOI
10 Gentile JH, Viviani C, Sparo MD, Arduino RC : Syphilitic meningomyelitis treated with ceftriaxone : case report. Clin Infect Dis 26 : 528, 1998   DOI
11 Horowitz HW, Valsamis MP, Wicher V, Abbruscato F, Larsen SA, Wormser GP, et al. : Brief report : cerebral syphilitic gumma confirmed by the polymerase chain reaction in a man with human immunodeficiency virus infection. N Engl J Med 331 : 1488-1491, 1994   DOI
12 Lee CW, Lim MJ, Son D, Lee JS, Cheong MH, Park IS, et al. : A case of cerebral gumma presenting as brain tumor in a human immunodeficiency virus (HIV)-negative patient. Yonsei Med J 50 : 284-288, 2009   DOI
13 Lee JP, Koo SH, Jin SY, Kim TH : Experience of meningovascular syphilis in human immunodeficiency virus infected patient. J Korean Neurosurg Soc 46 : 413-416, 2009   DOI
14 Lukehart SA, Hook EW 3rd, Baker-Zander SA, Collier AC, Critchlow CW, Handsfield HH : Invasion of the central nervous system by Treponema pallidum : implications for diagnosis and treatment. Ann Intern Med 109 : 855-862, 1988   DOI
15 Pall HS, Williams AC, Stockley RA : Intracranial gumma presenting as a cerebral tumour. J R Soc Med 81 : 603-604, 1988
16 Marra CM, Boutin P, McArthur JC, Hurwitz S, Simpson PA, Haslett JA, et al. : A pilot study evaluating ceftriaxone and penicillin G as treatment agents for neurosyphilis in human immunodeficiency virus-infected individuals. Clin Infect Dis 30 : 540-544, 2000   DOI
17 Marra CM, Maxwell CL, Smith SL, Lukehart SA, Rompalo AM, Eaton M, et al. : Cerebrospinal fluid abnormalities in patients with syphilis : association with clinical and laboratory features. J Infect Dis 189 : 369-376, 2004   DOI
18 Oblu N : Handbook of Clinical Neurology. New York : Elsevir, 1975
19 Rolfs RT, Joesoef MR, Hendershot EF, Rompalo AM, Augenbraun MH, Chiu M, et al. : A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. The Syphilis and HIV Study Group. N Engl J Med 337 : 307-314, 1997   DOI
20 Shann S, Wilson J : Treatment of neurosyphilis with ceftriaxone. Sex Transm Infect 79 : 415-416, 2003   DOI
21 Simon RP : Neurosyphilis. Arch Neurol 42 : 606-613, 1985   DOI
22 Uemura K, Yamada T, Tsukada A, Enomoto T, Yoshii Y, Nose T : Cerebral gumma mimicking glioblastoma on magnetic resonance images--case report. Neurol Med Chir (Tokyo) 35 : 462-466, 1995   DOI