Malignant syphilis. Severe variant of secondary syphilis

Malignant syphilis: a new and revised definition

“…It may be first evident with ocular findings such as scleral nodules and keratitis or with leonine facies (Figure 4). 33,43 A generalized lymphadenopathy is also common. Additionally, approximately 50% have cerebrospinal fluid alterations even without neurological symptoms 44 .…”

“…32 However, this is less likely, as in several early cases in which the epidemiology was identified, only one of the patients had malignant syphilis while the other connected patients had typical manifestations of syphilis. 33 Interestingly, most patients with HIV who develop malignant syphilis do not have a history of severely decreased CD4+ counts. 34 One group reported that 80% of HIV patients with malignant syphilis had CD4+ counts >200.…”

“…It may be first evident with ocular findings such as scleral nodules and keratitis or with leonine facies (Figure 4). 33,43 A generalized lymphadenopathy is also common.…”

“…Others suggest that malignant syphilis results from strains of T. pallidum with increased virulence, a theory supported by the development of malignant syphilis in immunocompetent patients 32 . However, this is less likely, as in several early cases in which the epidemiology was identified, only one of the patients had malignant syphilis while the other connected patients had typical manifestations of syphilis 33 …”

Ulceronecrotic rash in an immunocompetent individual

“…Diagnostic criteria are summarized in Table I. 2 The patient presented had a positive Treponema pallidum IgG serology followed by a serum rapid plasma reagin of 1:128. Enzyme-linked immunosorbent assay for Human immunodeficiency virus (HIV) and an interferongamma release assay were negative.…”