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A 51-year-old man with a history of antibiotic therapy for syphilis 1 month ago presented with syncope. Computed tomography revealed circumferential aortic wall thickening complicating severe stenosis of left main coronary ostium. Abnormalities in serologic and cerebrospinal fluid tests led to the diagnosis of syphilitic aortitis and neurosyphilis.

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Syphilis, an infection caused by , is well known for its ability to mimic other diseases across various organ systems, complicating timely diagnosis. Ocular syphilis, though rare, is a severe manifestation that can closely resemble other eye conditions, making early identification challenging. When conventional treatments fail to improve symptoms, considering syphilis in the differential diagnosis becomes crucial to avoid further complications.

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Neuromyelitis optica spectrum disorder (NMOSD) includes conditions with autoimmune genesis, which are manifested by attacks of optic neuritis (ON) and transverse myelitis (TM), and also express aquaporin 4 (NMO-IgG) or myelin oligo-endocytic glycoprotein (MOGAb) antibodies. In rare cases, the disease may also have a clinical presentation with only TM, without ON or with ON, without TM. These conditions are also included in the spectrum.

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Background And Objectives: This study aims to report the clinical, biological, and imaging features of cross-sectional study of neurosyphilis patients with leptomeningeal enhancement of spinal cord. Here, 51 neurosyphilis patients with leptomeningeal enhancement of spinal cord positivity are described, offering a promise in terms of early diagnosis, thereby enabling timely detection and treatment.

Methods: We retrospectively included all neurosyphilis patients enrolled in this study from December 2019 to January 2024.

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Uncommon Neurosyphilis: Subacute Meningomyelitis with Distinctive "Candle Guttering Appearance".

Indian J Radiol Imaging

January 2025

Division of Life Science and Medicine, Department of Dermatology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China.

Article Synopsis
  • The article discusses a unique case of neurosyphilis that exhibited a rare "candle guttering appearance" in radiological imaging.
  • After treating the syphilis, the patient's clinical symptoms and imaging results showed full recovery.
  • This case highlights the importance of recognizing distinctive radiological signs in diagnosing neurosyphilis.
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