title: Neurosyphilitic gumma in a homosexual man with HIV infection confirmed by polymerase chain reaction.
abstract: 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.
authors.affiliation: Laboratory Services, BC Centre for Disease Control, University of British Columbia, Vancouver, BC, USA. muhammad.morshed@bccdc.ca .
authors.forename: Muhammad G
authors.initials: MG
authors.lastname: Morshed
authors.forename: Min-Kuang
authors.initials: MK
authors.lastname: Lee
authors.forename: John
authors.initials: J
authors.lastname: Maguire
authors.forename: Thomas
authors.initials: T
authors.lastname: Zwimpfer
authors.forename: Brian
authors.initials: B
authors.lastname: Willoughby
authors.forename: Jason
authors.initials: J
authors.lastname: Clement
authors.forename: Richard I
authors.initials: RI
authors.lastname: Crawford
authors.forename: Jay
authors.initials: J
authors.lastname: Barberie
authors.forename: Shahid
authors.initials: S
authors.lastname: Gul
authors.forename: Hugh
authors.initials: H
authors.lastname: Jones
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D014057:Tomography, X-Ray Computed; D014210:Treponema pallidum / Q000235:genetics* / Q000302:isolation & purification*