Clinical, Radiological, and Pathological Features of Cerebral and Spinal Syphilitic Gumma: A Cross-Sectional Study

Area of Science:

• Neurology
• Infectious Diseases
• Pathology

Background:

• Syphilitic gumma is a rare tertiary syphilis manifestation with atypical presentations.
• This study focuses on the clinical, imaging, and biological characteristics of neurosyphilis patients with gumma.

Purpose of the Study:

• To report on seven cases of neurosyphilis with gumma.
• To highlight the importance of early diagnosis and treatment for improved prognosis.

Main Methods:

• A cross-sectional study of 397 neurosyphilis patients from January 2021 to June 2024.
• Identification and assessment of seven patients diagnosed with gumma, including sociodemographic, clinical, neuroimaging, and laboratory data.

Main Results:

• Seven out of 397 neurosyphilis patients (1.8%) had gumma, predominantly affecting individuals aged 46-70.
• Common symptoms included unilateral limb weakness/numbness, headache, memory decline, and lightning pain.
• Neuroimaging revealed nodular lesions; pathological findings showed neuronal degeneration and inflammation. Post-treatment, serum markers, WBC, and protein levels decreased, with MRI indicating remission.

Conclusions:

• Syphilitic gumma should be considered in patients with intracranial lesions and positive syphilis serology.
• Prompt diagnosis and active anti-syphilis treatment are essential for a better prognosis in gumma patients.