International Journal of STD & AIDS > Volume 19, Number 8 > Pp. 568-569

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Case reports

Neurosyphilitic gumma in a homosexual man with HIV infection confirmed by polymerase chain reaction

Muhammad G Morshed MSc PhD ^*  , Min-Kuang Lee MSc ^*, John Maguire MB FRCP(C)  , Thomas Zwimpfer MD FRCP(C) , Brian Willoughby MD CCFP , Jason Clement MD FRCP(C) ^**, Richard I Crawford MD FRCP(C)  ^**, Jay Barberie MD FRCP(C) ^**, Shahid Gul MD FRCP(C)  and Hugh Jones MD DipVen  

^* Laboratory Services, BC Centre for Disease Control (BCCDC); Department of Pathology and Laboratory Medicine, University of British Columbia (UBC); Vancouver General Hospital (VGH); Department of Family Practice, UBC; ^** St Paul's Hospital; Division of STI/HIV Prevention and Control, BCCDC, Canada

Correspondence to: Dr M G Morshed, Laboratory Services, BC Center for Disease Control, University of British Columbia, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, USA Email: muhammad.morshed{at}bccdc.ca

The brain gumma is a rare manifestation of the tertiary stage of syphilis. A case of neurosyphilitic gumma was confirmed by the Treponema pallidum polymerase chain reaction in a 46-year-old HIV-positive homosexual man. The patient presented with a severe headache and was hospitalized. A computed tomography scan was performed which revealed a left frontal lobe mass. Lymphoma was suspected. However, infectious disease diagnostics were performed on the cerebrospinal fluid that included investigations for syphilis and other microbiological agents such as Toxoplasma gondii. This revealed a reactive venereal disease research laboratory test, a reactive syphilis rapid plasma reagin and a reactive T. pallidum particle agglutination test. The patient was treated for syphilis till complete recovery.

Key Words: infectious diseases • public health • sexual medicine • Treponema pallidum • brain gumma

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