Syphilitic cerebral gumma with HIV infection

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

Research output: Contribution to journalArticle

41 Scopus citations

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 (US)
Pages (from-to)1282-1287
Number of pages6
JournalNeurology
Volume42
Issue number7
DOIs
StatePublished - Jul 1992

ASJC Scopus subject areas

  • Clinical Neurology

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    Berger, J. R., Waskin, H., Pall, L., Hensley, G., Ihmedian, I., & Post, M. J. D. (1992). Syphilitic cerebral gumma with HIV infection. Neurology, 42(7), 1282-1287. https://doi.org/10.1212/wnl.42.7.1282