A case of young woman with intracranial gumma developed within 1 year after <i>Treponema pallidum</i> infection

A 17-years-old woman visited the hospital due to convulsions. T₂-weighted images showed high intensity areas in right temporal lobe and left frontal lobe. Enhanced T₁-weighted images showed mass-like lesions on the dura mater. Based on mononuclear pleocytosis and a reactive fluorescent treponemal antibody-absorption test in the cerebrospinal fluid, neurosyphilis and intracranial gumma were diagnosed, and antibiotic therapy was initiated. After treatments, the high intensity areas improved, and she had no recurrence of symptoms or MRI images. Intracranial gumma usually develops in tertiary syphilis, more than 1 year after infection. In this case, intracranial gumma developed within 1 year after infection. Even if the patient is a young woman, it is necessary to consider the possibility of intracranial gumma and select appropriate examinations and treatments earlier.