Atypical secondary syphilis presentation in a patient with human immunodeficiency virus infection: a case report

Untreated syphilis may lead to severe complications. This infection has recently re-emerged in developed countries with a high number of cases coinfected with human immunodeficiency virus. In these patients, the skin lesions of secondary syphilis can be very atypical. We report the case of a 38-year...

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Bibliographic Details
Published in:Journal of medical case reports 2019-12, Vol.13 (1), p.360-4, Article 360
Main Authors: Yancheva, Nina, Petrova, Elena, Tchervenyakova, Tatyana
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Atypical presentation
Case Report
Case reports
Chicken pox
Chickenpox
Comorbidity
Dermatitis
Diagnosis
Diagnostic errors
Dolutegravir
Fever
Health aspects
Highly active antiretroviral therapy
HIV
HIV infections
HIV patients
Homosexuality
Human immunodeficiency virus
Industrialized countries
Infection
Infections
Laboratories
Metronidazole
Misdiagnosis
Penicillin
Penicillins
Sexually transmitted diseases
Skin
Staphylococcal infections
Syphilis
Virus diseases
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Summary:Untreated syphilis may lead to severe complications. This infection has recently re-emerged in developed countries with a high number of cases coinfected with human immunodeficiency virus. In these patients, the skin lesions of secondary syphilis can be very atypical. We report the case of a 38-year-old Bulgarian homosexual man who was coinfected with human immunodeficiency virus and syphilis. His skin contained multiple extensive necrotic lesions with abundant purulent secretion that covered his face, lips, scalp, and torso. Initial clinical diagnoses included varicella pustulosa and staphylococcal dermatitis. Human immunodeficiency virus infection in our patient had been established 2 years earlier in prophylactic studies, but had not been treated. Due to lack of penicillin, he was successfully treated with ceftriaxone, and the skin lesions underwent complete reversal. He also began antiretroviral therapy, which resulted in a significant effect on his immune status. Three months after the onset of antiretroviral therapy, he also achieved optimal viral suppression. This case emphasizes the importance of considering cutaneous secondary syphilis in the differential diagnosis of any inflammatory cutaneous disorder in individuals infected with human immunodeficiency virus.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-019-2291-5