title: A case of neurosyphilis showing a marked improvement of clinical symptoms and cerebral blood flow on single photon emission computed tomography with quantitative penicillin treatment.
abstract: A 31-year-old woman manifested significant emotional symptoms and personality change due to neurosyphilis; her clinical symptoms were improved with quantitative penicillin treatment. On admission, magnetic resonance imaging (MRI) showed no abnormal findings, while N-isopropyl-p-[123I] iodoamphetamine single photon emission computed tomography (123I-IMP SPECT) initially showed a remarkable increase in cerebral blood flow (CBF) in the cerebral cortex. This increase disappeared after improvement of the patient's clinical symptoms with treatment. It appears that the increase in CBF might have reflected an active inflammatory state of neurosyphilis and that its disappearance might therefore represent successful treatment with penicillin for neurosyphilis. Our case study suggests that single photon emission computed tomography (SPECT) is a useful method for evaluating an inflammatory state and for assessing the effect of therapy on neurosyphilis.
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305-8575, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ide
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Mizukami
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ashizawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Asada
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008279:Magnetic Resonance Imaging / Q000379:methods; D009494:Neurosyphilis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D015609:Organotechnetium Compounds; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D000900:Anti-Bacterial Agents; D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D010400:Penicillin G