Sarcoidosis-like granulomatosis revealing a tertiary syphilis

Numerous disorders can cause a systemic granulomatosis. We report a patient who presented a biopsy proven granulomatous skin eruption, fever, and atypical thoracic pain. Electrocardiogram showed a first-degree atrioventricular heart bloc. During follow-up he developed a panuveitis and oral corticost...

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Bibliographic Details
Published in:La revue de medecine interne 2009-09, Vol.30 (9), p.806-808
Main Authors: Hervier, B, Wastiaux, H, Freour, T, Masseau, A, Corvec, S, Armingeat, T, Hamidou, M
Format: Article
Language:fre
Subjects:
Adrenal Cortex Hormones - therapeutic use
Anti-Bacterial Agents - therapeutic use
Atrioventricular Block - diagnosis
Atrioventricular Block - etiology
Biopsy
Electrocardiography
Granuloma - pathology
Humans
Male
Panuveitis - diagnosis
Panuveitis - drug therapy
Panuveitis - etiology
Penicillin G - therapeutic use
Skin - pathology
Skin Diseases - pathology
Syphilis - complications
Syphilis - diagnosis
Syphilis - drug therapy
Syphilis Serodiagnosis
Treatment Outcome
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Summary:Numerous disorders can cause a systemic granulomatosis. We report a patient who presented a biopsy proven granulomatous skin eruption, fever, and atypical thoracic pain. Electrocardiogram showed a first-degree atrioventricular heart bloc. During follow-up he developed a panuveitis and oral corticosteroids were started. A diagnosis of systemic sarcoidosis was considered. Because of unfavourable ophthalmologic outcome, investigations were enlarged and revealed a highly positive serology for syphilis and VDRL both in serum and cerebrospinal fluid. Clinical outcome with penicillin G therapy was favorable. This observation reminds us the clinical polymorphism of syphilis, which can be presented as a systemic granulomatosis.
ISSN:0248-8663
DOI:10.1016/j.revmed.2009.01.003