Syphilitic Hepatitis in HIV-Infected Patients: A Report of 7 Cases and Review of the Literature

Abstract

Hepatic dysfunction is not uncommon in HIV-infected persons and is attributable to multiple causes. In the appropriate clinical setting, syphilitic hepatitis is an easily diagnosed and reversible etiology of liver dysfunction. The recognition of this entity will prevent unnecessary evaluation of abnormal liver enzyme levels in HIV-positive patients.

A Case of Syphilis Presenting with Initial Syphilitic Hepatitis and Serological Recurrence with Cerebrospinal Abnormality

“…The largest review to date, by Feher et al in 1975, showed the frequency of hepatitis to be 9.7% (17 syphilitic hepatitis out of 175 syphilis patients) (4); however, the presence of hepatitis C could not be ruled out at that time; hence, the exact frequency was unclear. By an extensive search of the MEDLINE database from 1966 to 2004, only 48 cases of syphilitic hepatitis were published in the English-language literature (2).…”

“…Syphilis is a systemic disease caused by the bacterium Treponema pallidum (T. pallidum), and a wide variety of organs are recognized to be involved, including the liver. The incidence of distinctive liver dysfunction, termed syphilitic hepatitis, is uncommon in early syphilis; however, this complication can occasionally occur, and several reports on syphilitic hepatitis have been published to date (2). Syphilitic hepatitis is a reversible condition, which responds well to antibiotics, therefore early recognition of the disease is important to facilitate early treatment as well as prevention of further spread of syphilis.…”

“…2 . The general physical examination was basically normal; however, there was generalized non-pruritic macular eruption all over his body ( Fig.…”

Answer to June 2013 Photo Quiz

“…The diagnostic criteria for syphilitic hepatitis are abnormal liver enzymes indicating hepatic involvement, serologic evidence of syphilis in conjunction with acute clinical presentation consistent with primary or secondary syphilis, and exclusion of alternative causes of hepatic damage with prompt liver function recovery after antimicrobial therapy (1,2). This case met all the aforementioned criteria.…”

SífiliS Cutânea e ViSCeral: apreSentação inuSitada

“…Trata-se de uma erupção frequentemente eritematosa que surge simetricamente no tronco e nos membros, podendo atingir a região palmoplantar. Apesar de esta descrição já estar estabelecida, outras formas de apresentação podem ser observadas (3,5) . Os sintomas gerais da sífilis secundária mais relatados são mal--estar (23-46%), cefaleia (9-46%), febre (5-39%), prurido (42%) e hiporexia (25%).…”