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Neurosyphilis

Case contributed by: Dr Roberto Schubert

Presentation:

HIV-positive patient. Good immune status under combined ART. Apraxia and left-right disorientation for about two weeks.

Patient Data:

Age: 48
Gender: Male
Race: Caucasian
From the case: Neurosyphilis
Modality: MRI

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T2

Multiple T2-hyperintense and T1 hypointense lesions around the trigonum and occipital horn of the left lateral ventricle. Diffuse and perifocal oedema in that region with mass effect. Restricted diffusion of the lesion centers and the entire region. There is ring- enhancement of the larger subcortical lesions and gyriform enhancement of the cortex in the cuneus.

Case Discussion:

Serologic tests for treponema pallidum were positive.

References:

  1. Tien RD, Gean-marton AD, Mark AS. Neurosyphilis in HIV carriers: MR findings in six patients. AJR Am J Roentgenol. 1992;158 (6): 1325-8. AJR Am J Roentgenol (abstract) - Pubmed citation

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