Malignant Syphilis in a Female Patient: A Case Report and Mini-Review

Malignant syphilis (MS) is a rare form of secondary syphilis with grotesque skin lesions, systemic manifestation and life-threatening complications. This article presents a case of MS in an immunocompetent 41-year-old female, who initially manifested with a generalized nonpruritic erythematous rash...

Full description

Saved in:
Bibliographic Details
Published in:Tropical medicine and infectious disease 2022-03, Vol.7 (3), p.47
Main Authors: Dimnik, Julija, Benko, Maja, Hosta, Violeta, Murnik Rauh, Andreja, Pagon, Andreja, Špik, Vesna Cvitković, Battelino, Saba, Vozel, Domen
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Biopsy
Blood
Case Report
Case reports
dermatology
diagnostic errors
Enzymes
Hearing loss
Hepatitis
HIV
Human immunodeficiency virus
Impetigo
Infections
Infectious diseases
Laboratories
Liver
Lymphatic system
Neck
Otolaryngology
Pain
sexually transmitted diseases
Skin
Syphilis
syphilis serodiagnosis
Ultrasonic imaging
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Malignant syphilis (MS) is a rare form of secondary syphilis with grotesque skin lesions, systemic manifestation and life-threatening complications. This article presents a case of MS in an immunocompetent 41-year-old female, who initially manifested with a generalized nonpruritic erythematous rash and systemic symptoms. She was mistreated for generalized impetigo and hepatitis attributed to chronic alcoholism. After partial recovery and a 3-month latent period, she developed infiltrated plaques with crusts on the trunk, head and neck; pharyngitis and laryngeal lesions; generalized lymphadenopathy and nonspecific systemic symptoms. Serologic tests confirmed syphilis, and cerebrospinal fluid analyses indicated the presence of anti-treponemal antibodies. Urine drug screening was positive for cannabinoids. The polymerase chain reaction from skin biopsy samples identified , confirmed with Warthin-Starry staining. Immunohistochemical analysis was uncharacteristic. Tertiary syphilis, neurosyphilis, ocular syphilis and otosyphilis were excluded. However, the patient was treated for neurosyphilis with benzylpenicillin (18 million IU intravenously daily, 14 days) and corticosteroids. No Jarisch-Herxheimer reaction occurred. Ten months after treatment, residual scars were visible, and 1 year later, she attempted suicide. Since MS can resemble other diseases, it should be suspected in a mentally ill patient with chronic drug abuse, systemic nonspecific manifestations and dermatological abnormalities, including the head and neck region.
ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed7030047