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NEUROLOGY 1986;36:1104
© 1986 American Academy of Neurology

Resolution of a gumma with steroid therapy

W. Shepherd Fleet, MD, Robert T. Watson, MD and William E. Ballinger, MD

Departments of Neurology (Drs. Fleet and Watson) and Pathology (Dr. Ballinger), College of Medicine, University of Florida, and the Veterans Administration Medical Center, Gainesville, FL.

Antibiotic usage has rendered neurosyphilis uncommon, and cerebral gummas are rare. Reduced awareness of cerebral gummas and abolition of serologic screening can delay diagnosis of this treatable disease. Diagnostic confusion between syphilitic and nonsyphilitic cerebral mass lesions can be increased by apparent resolution of a gumma during steroid therapy. Such an occurrence in a young woman emphasizes the need for serologic testing for syphilis in diagnosing cerebral mass lesions. A trial of conservative therapy using penicillin (with or without prednisone) should be considered for patients with intracerebral mass lesions and positive serologic findings.

Address correspondence and reprint requests to Dr. Watson, Department of Neurology, Box J-236, College of Medicine, Gainesville, FL 32610.

Accepted for publication December 18, 1985.




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A. E. Singh and B. Romanowski
Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features
Clin. Microbiol. Rev., April 1, 1999; 12(2): 187 - 209.
[Abstract] [Full Text] [PDF]




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