Korean J Intern Med.
2013 Mar;28(2):231-235. 10.3904/kjim.2013.28.2.231.
A case of secondary syphilis presenting as multiple pulmonary nodules
- Affiliations
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- 1Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. chepraxis@korea.ac.kr
- 2Department of Pathology, Korea University Ansan Hospital, Ansan, Korea.
- 3Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea.
- 4Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
- KMID: 1501779
- DOI: http://doi.org/10.3904/kjim.2013.28.2.231
Abstract
- Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement.
MeSH Terms
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Anti-Bacterial Agents/therapeutic use
Biopsy
Diagnosis, Differential
Humans
Lung Neoplasms/diagnosis
Male
Middle Aged
Multimodal Imaging
Multiple Pulmonary Nodules/diagnosis/drug therapy/*microbiology
Penicillin G Benzathine/therapeutic use
Predictive Value of Tests
Prostitution
Respiratory Tract Infections/diagnosis/drug therapy/*microbiology/transmission
Sex Workers
Syphilis/*diagnosis/drug therapy/*microbiology/transmission
Syphilis Serodiagnosis
Tomography, X-Ray Computed
Treatment Outcome
Unsafe Sex
Anti-Bacterial Agents
Penicillin G Benzathine
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