A 51-year-old woman with disorientation and amnesia

Denays, Roger; Collier, Andréa; Rubinstein, M.; Atsama, Patricia

doi:10.1016/s0140-6736(99)09151-5

Cited by 35 publications

(16 citation statements)

References 3 publications

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“…On MR images, regions of nonspecific T2 hyperintensity may be seen in the white matter. There have been reports of neurosyphilis that demonstrates mesiotemporal T2-weighted hyperintensity, a finding that mimics herpes encephalitis (96,99,100). Evidence of infarctions of various ages may be seen, and meningovascular syphilis should always be in the differential diagnosis for an HIV-infected patient who presents with cerebral infarction.…”

Section: Imaging Featuresmentioning

confidence: 99%

Central Nervous System Infections Associated with Human Immunodeficiency Virus Infection: Radiologic-Pathologic Correlation

Smith¹,

Smirniotopoulos²,

Rushing³

2008

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170

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Diseases of the central nervous system (CNS) in patients infected with the human immunodeficiency virus (HIV) result directly from HIV itself or from a variety of opportunistic agents. These infections include progressive multifocal leukoencephalopathy, toxoplasmosis, and cryptococcosis. A resurgence of tuberculosis and neurosyphilis has also been documented. Mass lesions, meningoencephalitis, demyelination, atrophy, and vascular lesions are the commonly encountered imaging findings. The introduction of highly active antiretroviral therapy (HAART) has improved both the clinical and radiologic findings in HIV-infected patients and reduced the number of opportunistic infections. In countries that use HAART, AIDS (acquired immunodeficiency syndrome) dementia complex is becoming the most common neurologic complication of HIV infection, whereas opportunistic infections are still the major cause of neurologic complications in patients from countries that do not commonly use HAART. Immune reconstitution inflammatory syndrome, which occurs in some patients in the weeks to months after the institution of HAART, may alter the typical imaging appearance of infectious diseases involving the CNS. Knowledge of the spectrum of imaging findings of these infectious diseases, as well as the effect that treatment has on imaging appearances, is important in the evaluation of HIV-infected patients.

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Section: Imaging Featuresmentioning

confidence: 99%

Central Nervous System Infections Associated with Human Immunodeficiency Virus Infection: Radiologic-Pathologic Correlation

Smith¹,

Smirniotopoulos²,

Rushing³

2008

RadioGraphics

170

104

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“…Also, the infection-induced small-vessel ischemic changes cause gliosis to ensue. 2 To our knowledge, none of the other similar cases [2][3][4][5] with neurosyphilis were also found to have HIV and it is unclear what role this concomitant infection may have played, if any.…”

mentioning

confidence: 96%

“…Mesial temporal lobe involvement secondary to neurosyphilis has already been described in the literature. [2][3][4][5] It is unclear what causes the T2 hyperintensity changes in the mesial temporal lobes of those patients. It is believed that the marked meningovascular inflammation causes vasogenic, cytotoxic, and interstitial edema to occur.…”

mentioning

confidence: 99%

Pearls & Oy-sters: Neurosyphilis presenting as mesial temporal encephalitis

2012

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“…Am ehesten handelte es sich um eine subakute (Meningo-)Enzephalitis. Insbesondere die auffälligen mesiotemporalen T2-und FLAIR-Hyperintensitäten deuten auf eine direkte Infektion des Hirnparenchyms durch die Spirochäten hin [1,2,4,13]. Hierfür spricht auch, dass diese Veränderungen unter effektiver antibiotischer Behandlung rückläufig sein kön-nen [2,9].…”

Section: Diskussionunclassified

Neurosyphilis

Otto

Hermans²,

Seifried³

et al. 2005

Nervenarzt

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Diagnosis of herpes simplex encephalitis in the acute stage is based on clinical symptoms (nonspecific prodromi, neuropsychological deficits, epileptic seizures) in combination with typical CSF abnormalities (lymphomonozytic pleocytosis) and MR imaging abnormalities assumed to be typical for herpes simplex encephalitis (increased fluid-attenuated inversion recovery and T2 hyperintensities in the mesiotemporal lobe region). Definite diagnosis of herpes simplex encephalitis is based on positive polymerase chain reaction in the CSF, usually available some days after hospital admission. Suspected herpes simplex encephalitis requires immediate treatment with acyclovir. Bacterial encephalitis caused by spirochetes may present with similar features but requires different treatment. This should therefore be considered in the differential diagnosis of herpes simplex encephalitis. We report a young patient with neurosyphilis whose correct diagnosis could be made only several days after beginning specific treatment.

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A 51-year-old woman with disorientation and amnesia

Cited by 35 publications

References 3 publications

Central Nervous System Infections Associated with Human Immunodeficiency Virus Infection: Radiologic-Pathologic Correlation

Central Nervous System Infections Associated with Human Immunodeficiency Virus Infection: Radiologic-Pathologic Correlation

Pearls & Oy-sters: Neurosyphilis presenting as mesial temporal encephalitis

Neurosyphilis

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