A Rare Presentation of Undiagnosed Systemic Syphilis: A Case Report and Review of Literature

Within the specialties of infectious diseases and dermatology, few rashes involve the palms and soles. The syphilitic rash has a pathognomonic association with these body surfaces and signals physicians to investigate this disease. However, the distinct presentations and symptoms associated with syp...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-08, Vol.14 (8)
Main Authors: Ruiz de Villa, Ariel, Haider, Asad A, Frimer, Leora, Lleshi, Amina, Bazikian, Yvette
Format: Article
Language:English
Subjects:
Abdomen
Antibodies
Antigens
Biopsy
Blood
Brain diseases
Case reports
Cytomegalovirus
Headaches
Hepatitis
Infections
Infectious Disease
Internal Medicine
Laboratories
Migraine
Penicillin
Polymerase chain reaction
Proteins
Pruritus
Serology
Skin
Syphilis
Tumor necrosis factor-TNF
Viral infections
Citations: Items that this one cites
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Description
Summary:Within the specialties of infectious diseases and dermatology, few rashes involve the palms and soles. The syphilitic rash has a pathognomonic association with these body surfaces and signals physicians to investigate this disease. However, the distinct presentations and symptoms associated with syphilis and the various stages of the disease make it diagnostically challenging. We herein report a rather intricate and unusual case of a patient who presented with a new-onset headache and blurred vision and a two-month history of diffuse pruritic maculopapular rash sparing the palms and soles. Several physicians had not established a diagnosis in the outpatient setting. Inpatient workup eventually revealed that the patient was suffering from secondary syphilis with neurological and ocular involvement. Management included a prolonged course of intravenous penicillin G leading to a complete recovery. We share images of the skin findings and the details of the intricate workup and hospital course, as well as a review of the literature.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.27911