Department of Neurosurgery, University Hospital Center Mohammed VI, Faculty of Medicine, Mohammed First University, Oujda, Morocco.
Department of Radiology, University Hospital Center Mohammed VI, Faculty of Medicine, Mohammed First University, Oujda, Morocco.
Spinal Cord Ser Cases. 2020 Jun 30;6(1):56. doi: 10.1038/s41394-020-0303-8.
Neurosyphilis is a sexually transmitted disease secondary to the invasion of the central nervous system by the Treponema pallidum. The spinal syphilitic gumma is rare.
We report a case of extradural cervical spinal syphilitic gumma revealed by spinal cord compression in a 58-year-old male. The epidural lesion was removed via a posterior approach. Histological examination revealed syphilis. Syphilis serologies were positive. Brain MRI showed an associated cerebro-meningeal syphilitic gumma. Antibiotic regime based on aqueous penicillin G was introduced for 14 days.
Currently, there is an increase in the frequency of syphilis and changes in its clinical manifestations. Neurosyphilis can take atypical forms. Spinal syphilitic gumma is a rare manifestation and its association with cerebral involvement is exceptional. Diagnosis is based on serologies in the blood and cerebrospinal fluid. The place of imagery, especially magnetic resonance imaging, is essential. Neurosyphilis should be discussed as a possible differential diagnosis in evaluation of spinal and cerebral lesions.
神经梅毒是一种由苍白密螺旋体侵犯中枢神经系统引起的性传播疾病。脊髓树胶肿性梅毒较为罕见。
我们报告了一例 58 岁男性因脊髓压迫而表现为颈椎硬膜外梅毒树胶肿的病例。通过后路切除硬膜外病变。组织学检查显示梅毒。梅毒血清学检查阳性。脑部 MRI 显示脑膜性脑脊膜梅毒树胶肿。采用水剂青霉素 G 进行为期 14 天的抗生素治疗。
目前，梅毒的发病率增加，临床表现也发生变化。神经梅毒可呈非典型形式。脊髓树胶肿性梅毒较为罕见，其与脑受累的关联也较为罕见。诊断基于血液和脑脊液中的血清学检查。影像学检查，特别是磁共振成像，具有重要意义。在评估脊髓和脑部病变时，应考虑神经梅毒作为可能的鉴别诊断。
