IDCases · 2026
Late syphilis presenting with extensive granulomatous cutaneous and pulmonary involvement.
СтатьяНазвание и аннотация: Перевод в очереди
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Shurmelova Ilona, Oellinger Angela, Salzer Helmut J F, Liu Drolaiz H W, Guenova Emmanuella, Hoetzenecker Wolfram
Аннотация
INTRODUCTION: Syphilis is a protean infection capable of mimicking various dermatological and systemic diseases, often complicating diagnosis in its later stages.
CASE PRESENTATION: A 26-year-old HIV-negative man with a history of inadequately monitored syphilis presented with headache, cough, and widespread erythematous plaques with central atrophy. Investigations revealed an RPR titer of 1:128 and positive CSF treponemal serology. Chest CT demonstrated peripheral nodular lung consolidations, and ophthalmologic exam showed signs of prior uveitis. A skin biopsy confirmed late-stage syphilis, revealing extensive dermal tuberculoid granulomas and gummatous necrosis. Following a 14-day course of intravenous penicillin G, the pulmonary lesions completely resolved, cutaneous lesions markedly improved, and the RPR titer appropriately declined at the six-month follow-up.
CONCLUSION: This case illustrates a rare presentation of late syphilis with concurrent pulmonary involvement and widespread granulomatous skin lesions, emphasizing the need for clinicians to maintain a high index of suspicion for atypical manifestations of Treponema pallidum.
CASE PRESENTATION: A 26-year-old HIV-negative man with a history of inadequately monitored syphilis presented with headache, cough, and widespread erythematous plaques with central atrophy. Investigations revealed an RPR titer of 1:128 and positive CSF treponemal serology. Chest CT demonstrated peripheral nodular lung consolidations, and ophthalmologic exam showed signs of prior uveitis. A skin biopsy confirmed late-stage syphilis, revealing extensive dermal tuberculoid granulomas and gummatous necrosis. Following a 14-day course of intravenous penicillin G, the pulmonary lesions completely resolved, cutaneous lesions markedly improved, and the RPR titer appropriately declined at the six-month follow-up.
CONCLUSION: This case illustrates a rare presentation of late syphilis with concurrent pulmonary involvement and widespread granulomatous skin lesions, emphasizing the need for clinicians to maintain a high index of suspicion for atypical manifestations of Treponema pallidum.