Atypical case of syphilitic hepatitis

A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1 week of jaundice, abdominal pain, cough and headache. Examination revealed scleral icterus, right upper quadrant tenderness and hepatomegaly. Initial investigations revealed hyperbilirubinaemia and elev...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2021-03, Vol.14 (3), p.e237851
Main Authors: Goldberg, Elliott, Edwards, Bathai, Krill, Kaleigh
Format: Article
Language:English
Subjects:
Adult
Antibodies
Antiviral drugs
Bacterial infections
Biopsy
Case Report
Case reports
COVID-19
Drug use
Epstein-Barr virus
Etiology
Family medical history
Headaches
Hepatitis
Hepatitis - diagnosis
Hepatitis - drug therapy
Hepatitis A
Hepatomegaly
Humans
Immunocompetence
Infections
Jaundice
Laboratories
Liver diseases
Male
Patients
Penicillin
Phosphatase
Serology
Syphilis
Syphilis - diagnosis
Syphilis - drug therapy
Viral infections
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:A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1 week of jaundice, abdominal pain, cough and headache. Examination revealed scleral icterus, right upper quadrant tenderness and hepatomegaly. Initial investigations revealed hyperbilirubinaemia and elevated transaminases. Serum studies were positive for antinuclear antibodies, antimitochondrial antibodies, and herpes simplex virus IgM. Despite being started on intravenous acyclovir, his bilirubin and transaminase levels continued to rise. He was subsequently tested for syphilis given his maculopapular rash on the soles of his feet and it returned positive. He improved clinically with the initiation of penicillin. In this case, we will discuss the presentation, diagnosis and treatment of syphilitic hepatitis.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-237851