title: Hypertrophic cervical spinal cord pachymeningitis due to Treponema pallidum infection.
abstract: Neurosyphilis is recognized as a potential cause of hypertrophic pachymeningitis, but modern reports are few. A middle-aged man presented to hospital with a 1 month history of lower limb pain and weakness. Cerebrospinal fluid analysis showed pleocytosis with high protein levels and a positive venereal disease research laboratory result. Cervical spinal cord resonance imaging disclosed a dural contrast enhancement suggestive of pachymeningitis. Biopsy of the dura mater revealed a thick inflammatory process. Despite being treated accordingly, the patient rapidly deteriorated and died. The patient was diagnosed as having subacute hypertrophic cervical pachymeningitis which caused spinal cord compression. Serological evidence of neurosyphilis was present. Physicians should still be aware of this cause of hypertrophic pachymeningitis.
authors.affiliation: Neurology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Thiago Cardoso
authors.initials: TC
authors.lastname: Vale
authors.forename: Thales Eduardo Caldeira
authors.initials: TE
authors.lastname: Moraes
authors.forename: Amanda
authors.initials: A
authors.lastname: Lara
authors.forename: Gláucia Fernandes
authors.initials: GF
authors.lastname: Cota
authors.forename: Paulo Pereira
authors.initials: PP
authors.lastname: Christo
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000209:etiology* / Q000382:microbiology*; D008875:Middle Aged; D013116:Spinal Cord / Q000382:microbiology / Q000473:pathology*; D013117:Spinal Cord Compression / Q000209:etiology / Q000382:microbiology; D014210:Treponema pallidum / Q000472:pathogenicity; D014211:Treponemal Infections / Q000150:complications*