Syphilitic cerebral gumma with HIV infection

J. R. Berger, H. Waskin, L. Pall, G. Hensley, I. Ihmedian, M. Judith Post

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Abstract

We describe two human immunodeficiency virus (HIV)-infected patients with syphilitic cerebral gummas. Both patients presented with a seizure disorder associated with an isolated, peripherally located, contrast-enhancing lesion of the brain on CT. Cranial MRI performed on one patient revealed durai thickening in the region of the lesion. A brain biopsy in that patient revealed a lymphoplasmacytic infiltrate with extensive perivascular inflammation. Clinical manifestations, radiographic resolution of the lesions, and a decline in nontreponemal serologic tests for syphilis followed high-dose aqueous penicillin therapy in both patients. These patients illustrate that (1) cerebral mass lesions occurring with HIV infection may result from syphilis; (2) seizures may be the presenting manifestation of this form of neurosyphilis; and (3) high-dose, intravenous, aqueous penicillin is effective in treating these lesions.

Original languageEnglish
Pages (from-to)1282-1287
Number of pages6
JournalNeurology
Volume42
Issue number7
StatePublished - Jul 1 1992

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ASJC Scopus subject areas

  • Neuroscience(all)

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Berger, J. R., Waskin, H., Pall, L., Hensley, G., Ihmedian, I., & Judith Post, M. (1992). Syphilitic cerebral gumma with HIV infection. Neurology, 42(7), 1282-1287.