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KMID : 0361620230580040355
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Journal of the Korean Orthopaedic Association
2023 Volume.58 No. 4 p.355 ~ p.359
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Atypical Progression of Syphilitic Myelitis
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Huh Jung-Wook
Kim Min-Woo
Jung Yun-Sung
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Abstract
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Syphilitic myelitis is a neurodegenerative lesion caused by syphilis infiltrating the myelin sheath. A 49-year-old male patient visited the authors’ hospital complaining of weakness and sensory disturbance in both lower extremities that had occurred six months earlier. A physical examination revealed numbness of both lower extremities, a positive Romberg test, and an absence of deep tendon reflex. In a serological test, RPR (rapid plasma reagin) (>titer 1:20), FTA-ABS (fluorescent treponemal antibody absorption test), IgG (Immunoglobulin G) was positive. The findings included T2-weighted MR (magnetic resonance) images with high signal below T7, especially in the posterior column, and VDRL (venereal disease research laboratory) positive in the cerebrospinal fluid. At a follow-up six months after treatment, the laboratory test revealed improvement. Syphilitic myelitis, which showed symptoms after a long latent period, but with rapid progression, has not been reported and can easily be misdiagnosed at the initial diagnosis. The report of this case is intended to be helpful in the differential diagnosis of other myelopathy and myelitis.
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KEYWORD
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neurosyphilis, tabes dorsalis, myelitis
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