Tomoko Okazaki    Department   Kawasaki Medical School  Kawasaki Medical School, Department of Stroke Medicine,    Position
Article types	症例報告
Language	English
Peer review	Peer reviewed
Title	Multiple cerebral syphilitic gummas mimicking brain tumor in a non-HIV-infected patient: A case report.
Journal	Formal name：Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Abbreviation：J Infect Chemother ISSN code：14377780/1341321X
Domestic / Foregin	Foregin
Volume, Issue, Page	25(3),pp.208-211
Author and coauthor	Ryota Sasaki, Natsuki Tanaka, Tomoko Okazaki, Taiji Yonezawa
Publication date	2019/03
Summary	We present a unique case of symptomatic early neurosyphilis in a non-HIV-infected patient. A 47-year-old man with a history of diabetes mellitus presented with generalized seizures. He did not manifest any neurological deficits. At first, multiple brain tumors were suspected based on findings from magnetic resonance imaging of the brain. However, serological and cerebrospinal fluid tests for syphilis yielded positive results, and the masses were reduced using amoxicillin. Multiple cerebral syphilitic gummas were therefore diagnosed. High-dose penicillin therapy was initiated and syphilitic gummas disappeared after five months. Treponema pallidum could invade the central nervous system at an early phase, and sometimes may be difficult to distinguish from malignant brain tumor. If intracranial lesions are identified in a syphilis-infected patient, cerebral syphilitic gumma should be considered as a differential diagnosis.
DOI	10.1016/j.jiac.2018.08.010
PMID	30249387