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We describe two human immunodeficiency virus(HIV)-infected patients with syphilis 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 dural 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. |
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brain biopsy
CAT scan
CAT scan,abnormal
CAT scan,contrast enhanced
gumma
human immunodeficiency virus type 1
neurosyphilis
penicillin
seizure
syphilis,diagnosis and treatment
syphilis,neurologic complications with
treatment of neurologic disorder
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