title: Mesiotemporal changes on magnetic resonance imaging in neurosyphilis.
abstract: We report a case of neurosyphilis with magnetic resonance imaging (MRI) brain scan findings compatible with a diagnosis of herpes simplex encephalitis with negative testing for herpes simplex virus in the cerebral spinal fluid. An extensive review of the literature has been undertaken revealing 24 cases worldwide where there are mesiotemporal changes on MRI concurrent with a diagnosis of neurosyphilis. Therefore, it is now well established that neurosyphilis, 'the great imitator', should be considered in the differential diagnosis in all patients demonstrating mesiotemporal changes on MRI, changes usually seen in herpes simplex encephalitis.
authors.affiliation: Department of Microbiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: R B
authors.initials: RB
authors.lastname: Saunderson
authors.forename: R C
authors.initials: RC
authors.lastname: Chan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid; D001714:Bipolar Disorder / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D010400:Penicillin G / Q000627:therapeutic use; D011595:Psychomotor Agitation / Q000209:etiology; D013702:Temporal Lobe / Q000473:pathology*; D014210:Treponema pallidum / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D010400:Penicillin G
keywords: herpes encephalitis; magnetic resonance imaging; mesiotemporal; syphilis