Neurosyphilis Manifesting as an Intramedullary Nodule with Rim Enhancement
Minkyeong Kim, MD, Sunhye Jung, MD, Jin-Hong Shin, MD, PhD
Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
Neurosyphilis in spinal cord presenting as isolated gumma is extremely rare, which poses a clinical
challenge since it is often mistaken for central nervous system tumor or parasite infection. With several
serologic tests, magnetic resonance image (MRI) provides a diagnostic clue. Here in, we report
a case with rapidly progressive weakness, whose spine MRI manifested isolated intramedullary
gumma and extensive cord edema. Venereal disease research laboratory of cerebrospinal fluid was
strongly reactive. Intravenous penicillin-G with high-dose steroid resulted in an excellent clinical
improvement.
Journal of Multiple Sclerosis 8(1):14-17, 2017