Neurosyphilis

Case contributed by Roberto Schubert
Diagnosis certain

Presentation

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

Patient Data

Age: 50 years
Gender: Male

Brain

mri

Multiple T2-hyperintense and T1 hypointense lesions around the trigonum and occipital horn of the left lateral ventricle. Diffuse and perifocal edema 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.

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