Syphilis, The Great Mimicker, Presents As a Rare Case of Concurrent Hepatitis and Gastroparesis

Shinn, Brianna; Kistler, C. Andrew; Dhanekula, Raja Koteswar; Civan, Jesse

doi:10.14309/crj.0000000000000067

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…Further, liver enzymes were not elevated while adherent to GENVOYA, an antiretroviral with known hepatotoxicity. As previously reported [ 1 ], due to the cross-reactivity of specific antibodies with the T. pallidum membrane, some diagnostic workup, including anti-smooth muscle antibodies, may be falsely elevated and will return to normal upon syphilis-targeted therapy. Our patient met previously outlined criteria by combining serological evidence of hepatic injury, infection with syphilis, exclusion of alternate etiologies, and response to treatment.…”

Section: Discussionmentioning

confidence: 90%

“…Our case presented a patient with primarily dermatologic complaints whose evaluation led to the diagnosis of syphilitic hepatitis. Rashes and dermatologic lesions are more often reported as painless and non-pruritic [ 1 - 4 , 8 , 9 ]. Sparse cases reported pruritic rashes but not subjective pain [ 4 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Syphilitic hepatitis is an uncommon, potentially underreported manifestation of early and secondary syphilis. Spirochete dissemination has variable systemic manifestations, including hepatic, gastrocolic, renal, and dermatologic injury [ 1 ]. Inflammatory response to spirochetes may be responsible for pathology, as evidenced by lesion histopathology displaying various inflammatory infiltrates [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Dawson¹,

Zhang²,

Salahi³

et al. 2022

Cureus

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Secondary syphilis has variable systemic manifestations, impersonating the presentation of more common pathologies, deceiving clinicians, and creating a difficult-to-diagnose patient. The case discussed combines hepatic syphilis with an uncommon syphilitic dermatologic presentation in a patient with HIV and a history of hepatitis A and B. Due to the challenge of diagnosis, the relative ease of confirming the diagnosis with serological assays, and reversibility of hepatic injury, the inclusion of syphilitic hepatitis on a differential diagnosis of hepatitis is warranted.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Dawson¹,

Zhang²,

Salahi³

et al. 2022

Cureus

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“…Even though physical examinations were performed (revealing genital ulcers in 25% of patients), clinical suspicion of syphilis was only present in 7.8% of cases. However, only a concurrently positive serologic test (reported in 79% of patients) assisted in reaching the correct diagnosis, along with a complete medical (including sexual) history, an accurate physical examination, and a high clinical suspicion [46][47][48][49][50][51][52][53][54][55][56].…”

Section: Discussionmentioning

confidence: 99%

Gastric Syphilis Presenting as a Nodal Inflammatory Pseudotumor Mimicking a Neoplasm: Don’t Forget the Treponema! Case Report and Scoping Review of the Literature of the Last 65 Years

Sinagra

Macaione

Stella

et al. 2023

Gastroenterology Insights

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Despite the fact that gastric syphilis is considered rare, it is reported as a type of organic involvement that is present in a large proportion of secondary syphilis cases, even though gastritis presenting with symptoms is extremely rare. Clinical, radiological, and endoscopic findings are non-specific and frequently mimic the symptoms of gastric adenocarcinoma or lymphoma, making diagnosis difficult. Immunostaining is required for this diagnosis. We would like to emphasize the importance of being suspicious of GS when a gastric mass exhibits the histologic features of an inflammatory pseudotumor (IPT), as previously reported for nodal IPT caused by luetic infection. We described a 56-year-old man who presented to the oncology department with a 3-month history of anorexia, epigastric pain, nausea, vomiting, and weight loss, as well as an initial radiological and endoscopic suspicion of gastric adenocarcinoma, in which immune staining allowed us to diagnose GS. In addition, we conducted an updated scoping review of the scientific literature to show the clinical, laboratory, and therapeutic findings in GS patients over the last 65 years.

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“…Specifically, in the gastrointestinal tract, syphilis can lead to hepatitis, gastritis, colitis, proctitis, and gastroparesis. [4][5][6] Herein, we describe a rare case of gastric syphilis that resembled lymphoma on gastroscopy.…”

Section: Introductionmentioning

confidence: 97%

Gastric Syphilis Mimicking Lymphoma: A Case Report

Cao¹,

Zhu²,

Xiang³

et al. 2023

IDR

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Gastric syphilis is a rare manifestation of syphilis that occurs in about 1% of cases and is often overlooked due to its non-specific signs and symptoms. We report a case of a 28-year-old Chinese woman who presented with epigastric pain, nausea, vomiting, hematemesis, alopecia, and weight loss. She tested positive for Helicobacter pylori ( H. pylori ), with rapid plasma reagin (RPR) and Treponema pallidum particle assay (TPPA) tests showing titers of 1:128 and 1:320, respectively. CT imaging revealed thickening of the gastric wall, exudation around the antrum, and multiple lymphadenopathies. Gastroscopy showed multiple irregular ulcers, which resembled lymphoma. However, biopsy results did not support the presence of lymphoma, but immunohistochemistry showed an abundance of syphilis spirochetes in the mucosal lamina propria and glands. This led to a diagnosis of gastric syphilis. The patient received standard treatment for syphilis as well as anti- H. pylori therapy, and her symptoms and endoscopic findings gradually improved and eventually resolved. We hope that this case report can provide valuable insights into the diagnosis and management of gastric syphilis, which can mimic other diseases like lymphoma.

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Syphilis, The Great Mimicker, Presents As a Rare Case of Concurrent Hepatitis and Gastroparesis

Cited by 3 publications

References 9 publications

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Gastric Syphilis Presenting as a Nodal Inflammatory Pseudotumor Mimicking a Neoplasm: Don’t Forget the Treponema! Case Report and Scoping Review of the Literature of the Last 65 Years

Gastric Syphilis Mimicking Lymphoma: A Case Report

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