Secondary syphilis with pulmonary involvement mimicking lymphoma: a case report

Florencio, Kelwya Bruna Vasconcelos; Costa, Anderson Dias da; Viana, T.C. de Melo; Gomes, Daniel Christiano de Albuquerque; Gouveia, Pedro Alves da Cruz

doi:10.1590/0037-8682-0044-2019

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…Severe acute pneumonia revealed the diagnosis in the case reported by Campos et al [ 8 ]. Florencio et al [ 9 ] reported syphilitic pulmonary involvement mimicking lymphoma with polyadenopathy and pulmonary nodules. Kassem Youssef et al [ 10 ] reported a case of syphilitic pulmonary involvement revealed by dyspnea, with thoracic imaging showing interstitial lung pattern, moderate pleural effusion, and hilar lymphadenopathy.…”

Section: Discussionmentioning

confidence: 99%

Case of Secondary Syphilis with Mucocutaneous, Articular, and Pulmonary Involvement in a 74-Year-Old Moroccan Man

2022

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Patient: Male, 74-year-old Final Diagnosis: Secondary syphilis Symptoms: Knee pain Medication:— Clinical Procedure: — Specialty: Rheumatology Objective: Challenging differential diagnosis Background: Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum . If untreated, primary syphilis can progress to secondary syphilis, which has a characteristic rash and diverse systemic features. This report is of a case of secondary syphilis with mucocutaneous, articular, and pulmonary involvement. Case Report: A 74-year-old Moroccan man presented with an 8-week history of bilateral knee pain and swelling. On examination, he had bilateral knee effusions. Articular puncture brought an inflammatory fluid with a significant presence of white blood cells. Inflammatory markers were elevated. X-rays of both knees showed bilateral osteoarthritis with intra-articular calcification in the left knee. Nonsteroidal anti-inflammatory drugs and colchicine were prescribed, but were ineffective. A closer clinical examination of the patient revealed pigmented papules on the palms, soles, oral mucosa, trunk, and genitals. Treponema pallidum hemagglutination assay and Venereal Disease Research Laboratory results were positive in the blood (titers 1: 32) and joint fluid. A computed tomography scan of the chest revealed a focal opacity in the lateral basal segment of the right lung. The diagnosis of secondary syphilis with mucocutaneous, articular, and pulmonary involvement was made. The evolution was favorable after a single intramuscular injection of benzathine-penicillin. Conclusions: Arthritis, mucocutaneous involvement, and lung lesions can be manifestations of secondary syphilis. A detailed anamnesis, clinical examination, serology, and imaging techniques are the pillars of diagnosing this condition.

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Section: Discussionmentioning

confidence: 99%

Case of Secondary Syphilis with Mucocutaneous, Articular, and Pulmonary Involvement in a 74-Year-Old Moroccan Man

2022

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“…In fact, in many cases, a lung biopsy was either not performed or not included, and treatment was based on serological confirmation and associated clinical features. 24,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Although not specifically stated, some descriptions suggest the morphology of an IPT 12,19 while others showed varied morphology (Table 1). Granulomas, seen in 5 cases, and lymphoplasmacytic infiltrates were the most common findings.…”

Section: Discussionmentioning

confidence: 99%

Syphilitic Pulmonary Inflammatory Pseudotumor: A Diagnostic Challenge

2020

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A 46-year-old man presented with nonproductive cough and lower limb swelling. Chest radiograph showed a left lower lobe lung mass and multiple subpleural nodules. Other investigations revealed that he had nephrotic syndrome. Core biopsies of the left lower lobe lung mass showed features of inflammatory pseudotumor with endarteritis obliterans and a lymphoplasmacytic infiltrate. Immunohistochemical stain for Treponema pallidum was positive. Resolution of the lung mass and nephrotic syndrome was achieved after treatment with intramuscular benzathine benzylpenicillin. The differential diagnosis of pulmonary inflammatory pseudotumor, manifestations of pulmonary syphilis, and a literature review of secondary syphilis of the lung are discussed.

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Secondary Syphilis With Pulmonary Involvement

Öz,

Absieha,

Dilegelen

et al. 2023

Infect Dis Clin Pract

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Syphilis is a multisystem infection caused by the spirochete Treponema pallidum. A 63-year-old man admitted to the hospital with chest pain and rashes on the chest wall and hands for 14 days. Thorax computed tomography revealed multiple nodular shadows in the bilateral lower lobes of the lung. Skin lesions were considered compatible with secondary syphilis. The antibody test for syphilis was positive. Screening for other associated sexually transmitted diseases (serology for HIV, hepatitis C, and hepatitis B) was negative. A specific therapy with crystallized penicillin G 2.4 MIU was applied. The key features for secondary syphilis diagnosis were positive serologic tests for syphilis and complete recovery on thorax computed tomography after antisyphilitic treatment. Pulmonary involvement in secondary syphilis is considered a rare occurrence.

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Secondary syphilis with pulmonary involvement mimicking lymphoma: a case report

Cited by 6 publications

References 10 publications

Case of Secondary Syphilis with Mucocutaneous, Articular, and Pulmonary Involvement in a 74-Year-Old Moroccan Man

Case of Secondary Syphilis with Mucocutaneous, Articular, and Pulmonary Involvement in a 74-Year-Old Moroccan Man

Syphilitic Pulmonary Inflammatory Pseudotumor: A Diagnostic Challenge

Secondary Syphilis With Pulmonary Involvement

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