The liver in secondary syphilis.

Liver involvement is uncommon in secondary syphilis and may resemble liver disease from alcoholism or acute viral hepatitis. Liver biopsy usually indicates nonspecific reactive hepatitis with or without cholestasis. Jaundice may sometimes be absent although liver damage is present. The liver abnormalities can be resolved with antibiotic therapy, but penicillin therapy may cause Jarisch-Herxheimer reaction. Syphilitic hepatitis should be considered in the differential diagnosis of obscure liver disease.