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一名HIV阴性患者的梅毒瘤性神经梅毒:病例报告。

Gummatous neurosyphilisin an HIV-negative patient: Case report.

作者信息

Ospino-Ayola José David, Lozano-Abdala María José, Sáenz-López José David, Almeida Valeria Sofia, Tenorio-Barragan Iván, Sarmiento Dickson Danna Cecilia

机构信息

Universidad del Sinú - Cartagena, Colombia.

Research Center in hemodynamics, vascular and endovascular surgery. Neurodinamia, Cartagena, Colombia.

出版信息

Radiol Case Rep. 2024 Jun 3;19(8):3529-3532. doi: 10.1016/j.radcr.2024.05.036. eCollection 2024 Aug.

Abstract

Syphilis is a chronic infectious disease, which dates back to the XV century and is caused by the spirochete treponema pallidum, capable of invading the central nervous system in any of its stages- Its incidence has increased in parallel to the HIV/AIDS pandemic, and the synergism between both pathologies is such. that it has become a public health problem in recent years. Here we present the case of a 31-year-old female patient, who consulted for headache associated with decreased visual acuity and provided an unenhanced head CT showing hypodense lesions in both thalamic regions, serological tests for syphilis were reactive and those for HIV were not reactive. The brain MRI with spectroscopy was reported in favor of cerebral toxoplasmosis, which was later ruled out with a study of cerebrospinal fluid. Management with penicillin G sodium IV for 6 weeks was indicated, achieving complete imaging resolution of her lesions.

摘要

梅毒是一种慢性传染病,可追溯到15世纪,由梅毒螺旋体引起,在其任何阶段都能侵入中枢神经系统。其发病率与艾滋病毒/艾滋病大流行同步上升,两种疾病之间的协同作用如此显著,以至于近年来它已成为一个公共卫生问题。在此,我们报告一例31岁女性患者的病例,该患者因视力下降伴头痛前来就诊,头颅CT平扫显示双侧丘脑区域有低密度病变,梅毒血清学检查呈阳性,艾滋病毒检查呈阴性。脑磁共振成像及波谱分析报告支持脑弓形虫病,但后来通过脑脊液检查排除了该病。给予静脉注射青霉素G钠治疗6周,其病变在影像学上完全消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb5/11178976/b07ffcf05614/gr1.jpg

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