Korean J Urogenit Tract Infect Inflamm.  2015 Apr;10(1):19-24. 10.14777/kjutii.2015.10.1.19.

Unusual Presentation of Secondary Syphilis in Korea: 2010-2014 Review

Affiliations
  • 1Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. piacekjh@hanmail.net

Abstract

The prevalence of syphilis differs according to the object and district. Diagnosis of syphilis remains challenging, as the absence of classical features of disease, such as the secondary syphilis orogenital lesion rash, might make accurate diagnosis difficult. However, recent studies have reported a growing prevalence of symptomatic syphilis in Korea. The main reason is the rise in primary and secondary syphilis. The most common clinical features of primary and secondary syphilis are orogenital lesions, masculopapapular rash, and generalized lymphadenopathy. An increasing number of unusual clinical presentations have been reported among secondary syphilis cases. The aim of this study was to remind us of the significance of syphilis by highlighting the unusual clinical presentation of secondary syphilis.

Keyword

Secondary syphilis

MeSH Terms

Diagnosis
Exanthema
Korea
Lymphatic Diseases
Prevalence
Syphilis*

Reference

1. Shin BS, Song JY, Chung BS, Choi KC. A clinical study of cases of syphilis referred to our dermatologic clinic (2002~2007): clinical presentation and changes in symptomatic stage. Korean J Dermatol. 2008; 46:1179–85.
2. Wöhrl S, Geusau A. Clinical update: syphilis in adults. Lancet. 2007; 369:1912–4.
Article
3. Biro L, Hill AC, Kuflik EG. Secondary syphilis with unusual clinical and laboratory findings. JAMA. 1968; 206:889–91.
Article
4. Korean Centers for Disease Control and Prevention. Infectious Diseases Surveillance Yearbook. [Internet]. Cheongju: Korean Centers for Disease Control and Prevention;2011. [cited 2012 Nov 12]. Available:. http://www.cdc.go.kr.
5. Reginato AJ. Syphilitic arthritis and osteitis. Rheum Dis Clin North Am. 1993; 19:379–98.
Article
6. Park KH, Lee MS, Hong IK, Sung JY, Choi SH, Park SO, et al. Bone involvement in secondary syphilis: a case report and systematic review of the literature. Sex Transm Dis. 2014; 41:532–7.
7. Ollé-Goig JE, Barrio JL, Gurgui M, Mildvan D. Bone invasion in secondary syphilis: case reports. Genitourin Med. 1988; 64:198–201.
8. Middleton S, Rowntree C, Rudge S. Bone pain as the presenting manifestation of secondary syphilis. Ann Rheum Dis. 1990; 49:641–2.
Article
9. Chung KY, Yoon J, Heo JH, Lee MG, Jang JW, Lee JB. Osteitis of the skull in secondary syphilis. J Am Acad Dermatol. 1994; 30:793–4.
Article
10. Thakore K, Viroslav A, Vansant J. Role of bone scintigraphy in the detection of periostitis in secondary syphilis. Clin Nucl Med. 1994; 19:536–41.
Article
11. Coyne K, Browne R, Anagnostopoulos C, Nwokolo N. Syphilitic periostitis in a newly diagnosed HIV-positive man. Int J STD AIDS. 2006; 17:421–3.
Article
12. Samarkos M, Giannopoulou C, Karantoni E, Papastamopoulos V, Baraboutis I, Skoutelis A. Syphilitic periostitis of the skull and ribs in a HIV positive patient. Sex Transm Infect. 2011; 87:44–5.
Article
13. Egan KM, Walters MC. Osseous and meningeal involvement in secondary syphilis. Dermatol Online J. 2012; 18:1.
Article
14. Toby M, Larbalestier N, Kulasegaram R, Teague A, Conway K, White J. Calvarial syphilis in an HIV-positive man. Int J STD AIDS. 2012; 23:365–6.
Article
15. Alraddadi B, Alrakawi S, Stone D. Thirty-two-year-old man with osteolytic skull lesion. Sex Transm Dis. 2013; 40:652.
Article
16. Boix V, Merino E, Reus S, Torrus D, Portilla J. Polyostotic osteitis in secondary syphilis in an HIV-infected patient. Sex Transm Dis. 2013; 40:645–6.
Article
17. Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist. 2004; 9:406–16.
Article
18. Park SY, Kang JH, Roh JH, Huh HJ, Yeo JS, Kim do Y. Secondary syphilis presenting as a generalized lymphadenopathy: clinical mimicry of malignant lymphoma. Sex Transm Dis. 2013; 40:490–2.
19. Kim GH, Kim BU, Lee JH, Choi YH, Chae HB, Park SM, et al. Cholestatic hepatitis and thrombocytosis in a secondary syphilis patient. J Korean Med Sci. 2010; 25:1661–4.
Article
20. Sherlock S. The liver in secondary (early) syphilis. N Engl J Med. 1971; 284:1437–8.
Article
21. Tramont EC. Treponema pallidum. Mandel GL, Douglas RG, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases Vol. 2. 5th ed.Philadelphia: Churchill Livingstone;2000. p. 2474–89.
22. Ozaki T, Takemoto K, Hosono H, Miyagawa K, Akimoto S, Nishimura N. Secondary syphilitic hepatitis in a fourteen-year-old male youth. Pediatr Infect Dis J. 2002; 21:439–41.
Article
23. Kim KY, Kim SH. Hematological aspects of congenital syphilis. Yonsei Med J. 1976; 17:142–50.
Article
24. Schlossberg D. Syphilitic hepatitis: a case report and review of the literature. Am J Gastroenterol. 1987; 82:552–3.
25. Young MF, Sanowski RA, Manne RA. Syphilitic hepatitis. J Clin Gastroenterol. 1992; 15:174–6.
Article
26. Fehér J, Somogyi T, Timmer M, Józsa L. Early syphilitic hepatitis. Lancet. 1975; 2:896–9.
Article
27. Lo JO, Harrison RA, Hunter AJ. Syphilitic hepatitis resulting in fulminant hepatic failure requiring liver transplantation. J Infect. 2007; 54:e115–7.
Article
28. Tsai KY, Brenn T, Werchniak AE. Nodular presentation of secondary syphilis. J Am Acad Dermatol. 2007; 57(2 Suppl):S57–8.
Article
29. Battistella M, Le Cleach L, Lacert A, Perrin P. Extensive nodular secondary syphilis with prozone phenomenon. Arch Dermatol. 2008; 144:1078–9.
Article
30. Jang YH, Sim JH, Kim YC, Lee ES. Single nodular lesion on the scalp: a quiz. Diagnosis: nodular secondary syphilis. Acta Derm Venereol. 2011; 91:491–4.
31. David G, Perpoint T, Boibieux A, Pialat JB, Salord H, Devouassoux M, et al. Secondary pulmonary syphilis: report of a likely case and literature review. Clin Infect Dis. 2006; 42:e11–5.
Article
32. Coleman DL, McPhee SJ, Ross TF, Naughton JL. Secondary syphilis with pulmonary involvement. West J Med. 1983; 138:875–8.
33. Zaharopoulos P, Wong J. Cytologic diagnosis of syphilitic pleuritis: a case report. Diagn Cytopathol. 1997; 16:35–8.
Article
34. Cholankeril JV, Greenberg AL, Matari HM, Reisner MR, Obuchowski A. Solitary pulmonary nodule in secondary syphilis. Clin Imaging. 1992; 16:125–8.
Article
35. Kim SJ, Lee JH, Lee ES, Kim IH, Park HJ, Shin C, et al. A case of secondary syphilis presenting as multiple pulmonary nodules. Korean J Intern Med. 2013; 28:231–5.
Article
36. Holland BA, Perrett LV, Mills CM. Meningovascular syphilis: CT and MR findings. Radiology. 1986; 158:439–42.
Article
37. Darwish BS, Fowler A, Ong M, Swaminothan A, Abraszko R. Intracranial syphilitic gumma resembling malignant brain tumour. J Clin Neurosci. 2008; 15:308–10.
Article
38. Lee CW, Lim MJ, Son D, Lee JS, Cheong MH, Park IS, et al. A case of cerebral gumma presenting as brain tumor in a human immunodeficiency virus (HIV)-negative patient. Yonsei Med J. 2009; 50:284–8.
Article
39. Pall HS, Williams AC, Stockley RA. Intracranial gumma presenting as a cerebral tumour. J R Soc Med. 1988; 81:603–4.
Article
40. Uemura K, Yamada T, Tsukada A, Enomoto T, Yoshii Y, Nose T. Cerebral gumma mimicking glioblastoma on magnetic resonance images–case report. Neurol Med Chir (Tokyo). 1995; 35:462–6.
41. Yoon YK, Kim MJ, Chae YS, Kang SH. Cerebral syphilitic gumma mimicking a brain tumor in the relapse of secondary syphilis in a human immunodeficiency virus-negative patient. J Korean Neurosurg Soc. 2013; 53:197–200.
Article
42. Skowron G, Wang X, Gupta E. Infectious syphilis: the return of the great imitator to Rhode Island. Med Health R I. 2012; 95:245–8.
43. Breznik V, Potočnik M, Miljković J. Papulonodular secondary syphilis in a 52-year-old non-HIV heterosexual patient. Acta Dermatovenerol Alp Pannonica Adriat. 2010; 19:27–30.
44. Moon HS, Park K, Lee JH, Son SJ. A nodular syphilid presenting as a pseudolymphoma: mimicking a cutaneous marginal zone B-cell lymphoma. Am J Dermatopathol. 2009; 31:846–8.
Article
45. ul Bari A, Raza N. Secondary syphilis clinically mimicking pseudolymphoma of the face. Dermatol Online J. 2006; 12:20.
Article
46. Roett MA, Mayor MT, Uduhiri KA. Diagnosis and management of genital ulcers. Am Fam Physician. 2012; 85:254–62.
47. Jo J, Heo ST, Kim JW, Kim J, Yu JR. Secondary syphilis with nodular vasculitis mimicking Behçet's disease. Infect Chemother. 2013; 45:451–4.
Article
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