Neurosyphillis, Stroke, Brain Mass
Mar 17, 2013
My partner has had HIV since 2006 w/undetectable VL until a self prescribed drug holiday 8mo. In December was diagnosed with neurosyphilis & brain leison, the leison doubled in size durin the 14 days or IV penicillin(but then shrank a tiny bit while on ceftriaxon cause he became allergic when re administering penicillin cause neurosyphilis wasn't gone) His physical sypmtoms (hemiplegia, dysarthria, and aphesia) continued to worsen, after demanding steroids the symptoms stopped worsening, now his whole right side is paralyzed, cannot speak, and is NPO with a Jtube. Doctors say they can't biopsy because the leison sits on the brain stem. Do you have any idea what could be the cause of this? He tested negative for cancer cells, pet scan didn't light up for cancer (but could be low grade lymphoma), neg for taxoplasmosis, cmv, JC virus, EB virus. Is there something they could be missing? I can't sit back and wait to see if this mass grows and takes him while they do nothing to treat it. Thanks
Response from Dr. Holodniy
The rapid growth of the lesion suggests an infectious cause. It sounds like the doctors are doing an adequate work-up with scans and tests. In addition to the mentioned infections, I assume that tuberculosis and fungal infections were also looked for in the spinal fluid? Finally, what was the CSF VDRL level and did it decline after antibiotic treatment?
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