Syphilitic osteitis of the skull presenting as a complication of secondary syphilis.

Syphilis still remains a common infection in the United States with increasing prevalence in the last two decades. With HIV co-infection (even if well-controlled), syphilis as well as other infections can have unusual presentations. In this case report, we present a case of secondary syphilis complicated by neurosyphilis and osteitis of the skull treated with a prolonged course of intravenous penicillin. We review the published literature regarding syphilitic calvarial osteitis, a rare manifestation of this protean infection, to discuss areas of uncertainty regarding diagnostic and treatment decisions.