ro13-9904 and Hypesthesia

We report a rare case of syphilitic meningomyelitis presenting with visceral crisis and possessing characteristic imaging findings.. The patient, a 50-year-old woman, complained of pain in the upper abdomen and back. She then developed numbness in both lower extremities and weakness in the left lower limb.. Magnetic resonance imaging (MRI) of the spinal cord revealed the candle guttering sign and irregular enhancement at the T6 level. Rapid plasma reagin test of the cerebrospinal fluid yielded a titer of 1:8. Thus, the patient was diagnosed with syphilitic meningomyelitis.. She was treated with ceftriaxone and dexamethasone after the failure of penicillin treatment.. She could perform the activities of daily living, and her pain completely disappeared.. A patient with syphilitic meningomyelitis can present with visceral crisis caused by the involvement of the posterior nerve roots or the posterior horn, which usually occurs in patients with tabes dorsalis. Considering the non-specific symptoms and MRI features, we should be aware that abdominal pain may be a symptom of myelopathy, and syphilitic meningomyelitis ought to be taken into account in a patient with longitudinally extensive myelitis.

Topics: Abdominal Pain; Anti-Bacterial Agents; Anti-Inflammatory Agents; Back Pain; Ceftriaxone; Dexamethasone; Female; Humans; Hypesthesia; Lower Extremity; Middle Aged; Pain; Stomach; Tabes Dorsalis

We report the first known Australian case of probable neurobrucellosis, in a young feral-pig shooter who presented with episodic left-sided visual loss and left-sided numbness and headache. Treatment with intravenous ceftriaxone and oral rifampicin, doxycycline and trimethoprim–sulfamethoxazole resulted in a good clinical response.

Topics: Adult; Agglutination Tests; Agricultural Workers' Diseases; Animals; Anti-Bacterial Agents; Antibodies, Bacterial; Australia; Brucella; Brucellosis; Ceftriaxone; Central Nervous System Bacterial Infections; Doxycycline; Drug Therapy, Combination; Headache; Humans; Hypesthesia; Male; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination; Vision Disorders