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Case Reports
. 2014 Nov 24:2014:bcr2014205608.
doi: 10.1136/bcr-2014-205608.

Chameleons everywhere

Katharina Sprenger  1 , Hansjakob Furrer  2
Affiliations
Case Reports

Chameleons everywhere

Katharina Sprenger et al. BMJ Case Rep. .

Abstract

We report the case of an HIV-infected man returning from Thailand with secondary syphilis with general symptoms, hepatitis and a pulmonary mass lesion. A cerebrospinal fluid examination showed no signs of neurosyphilis. Two months after successful treatment with benzathine penicillin he presented with a mass lesion in the brain suspected to be a glioma or glioblastoma, which turned out to be a syphilitic gumma. Syphilis remains a great imitator in clinical medicine. Syphilitic brain gummata can develop within a few months.

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Figures

Figure 1
Figure 1
Thorax CT scan 31 May: wedge-shaped mass lesion in the lingual.
Figure 2
Figure 2
Thorax CT scan 29 September: regredient mass lesion in the lingula.
Figure 3
Figure 3
Brain MRI 1 October: mass lesion measuring 28×20×22 mm in the left parietal lobe.
See this image and copyright information in PMC

References

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    1. Fargen KM, Alvernia JE, Lin CS et al. . Cerebral syphilitic gummata: a case presentation and analysis of 156 reported cases. Neurosurgery 2009;64:568–75. - PubMed
    1. Merritt HH, Adams RD, Solomon HC. Neurosyphilis. New York: Oxford University Press, 1946.
    1. Oblu N, Stanciu A, Sandulescu G et al. . Cerebral syphilitic gumma. 3 cases reports. Neurochirurgie 1970;16:249–58. - PubMed

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