A case of secondary syphilis with hepatitis

Hepatitis is a rare clinical manifestation of syphilis. In this report a 50 years old male patient who was diagnosed as secondary syphilis presenting with hepatitis has been discussed. The patient was admitted to the hospital with high fever and skin rash, and his history revealed a suspected sexual...

Full description

Saved in:
Bibliographic Details
Published inMikrobiyoloji bülteni Vol. 41; no. 2; p. 291
Main Authors Tanyel, Esra, Taşdelen Fişgin, Nuriye, Sarikaya Genç, Hanife, Tülek, Necla
Format Journal Article
LanguageTurkish
Published Turkey 01.04.2007
Subjects
Anti-Bacterial Agents - administration & dosage
Cardiolipins
Ceftriaxone - administration & dosage
Cholesterol
Diagnosis, Differential
Exanthema
Female
Fever
Hemagglutination Tests
Hepatitis - diagnosis
Hepatitis - drug therapy
Hepatitis - etiology
Hepatomegaly
Humans
Jaundice
Lymphatic Diseases
Male
Middle Aged
Phosphatidylcholines
Splenomegaly
Syphilis - complications
Syphilis - diagnosis
Syphilis - drug therapy
Syphilis Serodiagnosis
Online AccessGet more information

Cover

More Information
Summary:Hepatitis is a rare clinical manifestation of syphilis. In this report a 50 years old male patient who was diagnosed as secondary syphilis presenting with hepatitis has been discussed. The patient was admitted to the hospital with high fever and skin rash, and his history revealed a suspected sexual contact. He indicated that he had been admitted to a health center eight months ago because of the presence of a penile wound, however VDRL (Venereal Disease Research Laboratory) test was negative at that time. Fever (39.5 degrees C), jaundice in skin and sclera, generalized macular and maculopapular skin rash including palms and soles, lymphadenopathy and hepatosplenomegaly were detected in physical examination. Laboratory tests yielded elevated erythrocyte sedimantation rate, high CRP levels and elevated liver enzyme levels, however viral hepatitis markers together with VDRL and TPHA (Treponema pallidum hemagglutination) tests were found negative. Ceftriaxone therapy was initiated because of the presence of high fever (40 degrees C) and 30 leukocyte/mm3 in urine, and the absence of bacteria in Gram staining of urine sample. However, the antibiotic therapy was discontinued since fever persisted. As the clinical signs and symptoms strongly indicated syphilis, the serological tests were repeated and VDRL positivity at 1/8 and TPHA positivity at 1/1280 titers were detected. Ceftriaxone therapy was restarted and continued for 14 days with complete cure. Since the spouse of the patient was also found VDRL and TPHA positive, she was treated with penicilin. The presentation of this case emphasized the importance of repeating the serological tests for syphilis since they might be negative in the early stages of infection. The case also indicates that syphilis should be considered in the differential diagnosis of hepatitis.
ISSN:0374-9096