Mu LK, Cheng LF, Ye J, Zhao MY, Wang JL. Cerebral syphilitic gumma misdiagnosed as brain abscess: A case report. World J Clin Cases 2024; 12(3): 650-656 [PMID: 38322467 DOI: 10.12998/wjcc.v12.i3.650]
Corresponding Author of This Article
Li-Kun Mu, MMed, Neurosurgeon, Department of Neurosurgery, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying 257099, Shandong Province, China. sjwmlk@163.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 26, 2024; 12(3): 650-656 Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.650
Cerebral syphilitic gumma misdiagnosed as brain abscess: A case report
Li-Kun Mu, Li-Feng Cheng, Jing Ye, Meng-Yan Zhao, Jin-Long Wang
Li-Kun Mu, Li-Feng Cheng, Jing Ye, Meng-Yan Zhao, Jin-Long Wang, Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying 257099, Shandong Province, China
Author contributions: Mu LK and Cheng LF conceived and designed the study; Mu LK, Cheng LF, and Ye J provided the study materials and collected the cases; Mu LK and Zhao MY wrote the manuscript; Mu LK and Wang JL confirmed the authenticity of the raw data.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Kun Mu, MMed, Neurosurgeon, Department of Neurosurgery, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying 257099, Shandong Province, China. sjwmlk@163.com
Received: November 15, 2023 Peer-review started: November 15, 2023 First decision: December 15, 2023 Revised: December 22, 2023 Accepted: January 2, 2024 Article in press: January 2, 2024 Published online: January 26, 2024 Processing time: 63 Days and 21.9 Hours
Abstract
BACKGROUND
Cerebral syphilitic gumma is a relatively rare clinical disease. Its clinical manifestations are non-specific, and the imaging manifestations are similar to other intracranial occupying lesions, often misdiagnosed as tumors or abscesses. There are few reports on this disease in the relevant literature. To our knowledge, we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases.
CASE SUMMARY
We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics. The clinical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported. Clinical manifestations, classifications, and diagnostic points were retrospectively analyzed. The patient was admitted to the hospital with fever and limb weakness. Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum Treponema pallidum gelatin agglutination test. The patient was misdiagnosed as having a brain abscess and underwent a craniotomy. A postoperative pathological diagnosis of syphilis gumma was made. The patient improved and was discharged after penicillin anti-syphilis treatment. Follow-up recovery was satisfactory.
CONCLUSION
Cerebral syphilitic gumma is rare in clinical practice, and it is often misdiagnosed and missed. Clinical diagnosis should be considered in combination with multiple examinations.
Core Tip: Cerebral syphilitic gumma is a relatively rare clinical disease. Its clinical manifestations are non-specific, and the imaging manifestations are similar to other intracranial occupying lesions, often misdiagnosed as tumors or abscesses. There are few reports on this disease in the relevant literature. To our knowledge, we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess. We report this case and provide useful information for clinical doctors on neurosyphilis diseases.
