Spinal Intramedullary Syphilitic Gumma: An Unusual Presentation of Neurosyphilis

Extraosseous extradural tuberculous granuloma of the cervical spine: A case report and review of intraspinal granulomatous infections

Neurosyphilis, which is caused by Treponema pallidum, is a rare sexually transmitted disease involving the central nervous system (CNS). Among all the sub-categories, spinal syphilitic gumma is extremely rare. In previous literature, limited cases of spinal syphilitic gumma have been reported, most of which underwent surgery treatment. In this study, we reported a 46-year-old man, who presented with 5-day numbness of bilateral lower limbs, lower back pain, and irregular defecation. Magnetic resonance imaging (MRI) revealed a homogeneous peripheral enhancement and intramedullary nodule at the T7 level with extensive thoracic cord edema. Combining with laboratory examination results, the syphilitic gumma was considered. One month after the administration of penicillin G, the symptoms vanished. Six months later, MRI indicated no intramedullary nodule.

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Diagnosis and Treatment of Spinal Syphilitic Gumma: A Case Report.

Em face do aumento da incidencia da sifilis na populacao em geral observada depois da decada de 50, foi feita uma primeira investigacao procurando apreciar a possivel repercussao deste fenomeno entre os pacientes de servicos neurologicos e psiquiatricos de Sao Paulo. Este estudo revelou que, ao contrario do esperado, houve uma acentuada diminuicao da incidencia da neurossifilis no periodo 1936-1964 e, ao mesmo tempo, foi verificado um decrescimo das formas clinicas parenquimatosas da neurossifilis e um predominio das meningo-vasculares. O presente trabalho e uma continuacao desta pesquisa. O material utilizado nesta investigacao e representado exclusivamente pelas observacoes clinicas de 148 pacientes selecionados dentre 34.430 individuos examinados por motivos diversos no periodo 1962-1981 no Servico de Neurologia da Escola Paulista de Medicina. Este estudo complementar, que abrange um periodo de 20 anos consecutivos, revelou que o numero de casos de neurossifilis foi relativamente estavel, com uma incidencia anual de aproximadamente 1:200 e que a proporcao de formas clinicas classicas de neurossifilis vem diminuindo progressivamente, atraves dos anos, de sorte que atualmente predominam de modo absoluto formas clinicas de observacao rara em tempos passados.

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Incidência da neurossifilis e frequência de suas formas clínicas no período 1962-1981

Multiple Spinal Syphilitic Gummas Diagnosed by Postoperative Histopathology and Antibiotic Responsiveness: A Case Report

E relatado o caso de uma paciente de 48 anos que apresentou um quadro de paraparesia crural espastica muito acentuada com evolucao de dois meses, acompanhada de disturbios da sensibilidade e disturbios esfincterianos. As mielografias ascendente e descendente revelaram processo expansivo intra-raquideo ao nivel de T3. A laminectomia de T2-T4 e o exame histopatologico mostraram tratar-se de uma goma sifilitica justaposta a medula. As evolucoes clinica e dos exames complementares sao comentadas a luz de algumas observacoes encontradas na literatura.

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Goma sifilitica intra-raquidea causando compressão medular: relato de um caso

A case of an syphilitic intraspinal gumma is reported. A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances. Myelography revealed an intraspinal tumor at T3 level. Surgical exploration by dorsal laminectomy showed a syphilitic gumma attached to the spinal cord. Clinical observations and laboratory studies are discussed. Revision and comments on previous reports are presented.

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Intraspinal syphilitic gumma causing spinal cord compression. Report of a case

A case of an syphilitic intraspinal gumma is reported. A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances. Myelography revealed an intraspinal tumor at T3 level. Surgical exploration by dorsal laminectomy showed a syphilitic gumma attached to the spinal cord. Clinical observations and laboratory studies are discussed. Revision and comments on previous reports are presented. Spinal cord compression by intraspinal syphilitic gumma: report of a case

https://www.arquivosdeneuropsiquiatria.org/wp-content/uploads/articles_xml/1678-4227-anp-S0004-282X1979000200012/1678-4227-anp-S0004-282X1979000200012.pdf

Leopoldo Prezia Araujo

Papers

Goma sifilitica intra-raquidea causando compressão medular: relato de um caso

Intraspinal syphilitic gumma causing spinal cord compression. Report of a case

Spinal cord compression by intraspinal syphilitic gumma: report of a case