Uncommon cause of progressive infectious paraplegia: Syphilitic gums

Abstract

Introduction: Syphilitic gums of the central nervous system are rare; the intra-spinal localization of then is periodically described. Moreover, since the advent of antibiotherapy, the occurrence of tertiary syphilis has become rare and its diagnosis has become more complex, that has made it difficult to study the later forms of treponemal medullary infections. However, it is predominant in HIV-infected populations. Case Report: A 56-year-old man, who had an earlier history of treated neurosyphylis, was admitted with the complaint of walking difficulty. MRI showed a heterogeneous signal abnormalities of the spinal cord of D9 to D12, in favor of syphilitic gumma. It seemed useful to review the MRI aspects of the syphilitic gum and its semiology as well as its important differentials. Conclusion: Syphilitic gums are rare pathological occurrences in central nervous system. The advent of magnetic resonance imaging (MRI) diagnostic techniques has led to an increased sensitivity for asymptomatic disease and diagnosis that is more frequent. The reference treatment remained penicillin associated with corticotherapy. The rarity of this disease and the nonspecific radiological findings, often makes it difficult to detect this disease.