Acute Inflammatory Polyarthritis: A Rare Presentation of Secondary Syphilis

Ruan, Xu Cong; Lim, Joel Hua Liang; Tey, Hong Liang

doi:10.47102/annals-acadmedsg.v46n2p72

Cited by 2 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Treponema pallidum hemagglutination assay and VDRL results were positive in the blood as well as in the joint fluid. As in previously reported cases for secondary syphilis involving joint and bone, there was complete resolution of symptoms following treatment with benzathine penicillin [ 5 – 7 ].…”

Section: Discussionsupporting

confidence: 70%

“…Syphilitic arthritis is reported in congenital and tertiary syphilis [ 20 ], but joint involvement in secondary syphilis is rarely reported [ 5 ]. The joint disorders in secondary syphilis are polyarthralgia, monoarthritis, or migratory polyarthritis [ 20 ], and the most affected joints are the knees, hips, shoulders, and proximal interphalangeal joints [ 5 , 6 , 20 , 21 ]. Joint involvement usually occurs 3 to 12 weeks after the onset of the secondary stage [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Joint involvement usually occurs 3 to 12 weeks after the onset of the secondary stage [ 22 ]. The differential diagnosis of syphilitic arthritis is septic arthritis, rheumatoid arthritis, rheumatic fever, reactive arthritis, psoriatic arthritis, gout, and chondrocalcinosis [ 5 , 23 ]. Other musculoskeletal symptoms of secondary syphilis include bone involvement and tenosynovitis [ 7 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…These manifestations concern 25% of patients after 1 to 2 months of primary syphilis [ 26 ]. With the current epidemic of syphilis, practitioners will likely encounter these manifestations [ 5 ]. Cutaneous lesions resolved 2 to 3 weeks following treatment with benzathine penicillin [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…If untreated, primary syphilis can progress to secondary syphilis, which has a characteristic rash and diverse systemic features [ 3 , 4 ]. Articular, mucocutaneous, and pulmonary involvement during secondary syphilis have been reported in several case reports [ 5 – 11 ]. Syphilis represents a diagnostic challenge for the practitioner because it mimics several conditions [ 12 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Case of Secondary Syphilis with Mucocutaneous, Articular, and Pulmonary Involvement in a 74-Year-Old Moroccan Man

2022

View full text Add to dashboard Cite

Patient: Male, 74-year-old Final Diagnosis: Secondary syphilis Symptoms: Knee pain Medication:— Clinical Procedure: — Specialty: Rheumatology Objective: Challenging differential diagnosis Background: Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum . If untreated, primary syphilis can progress to secondary syphilis, which has a characteristic rash and diverse systemic features. This report is of a case of secondary syphilis with mucocutaneous, articular, and pulmonary involvement. Case Report: A 74-year-old Moroccan man presented with an 8-week history of bilateral knee pain and swelling. On examination, he had bilateral knee effusions. Articular puncture brought an inflammatory fluid with a significant presence of white blood cells. Inflammatory markers were elevated. X-rays of both knees showed bilateral osteoarthritis with intra-articular calcification in the left knee. Nonsteroidal anti-inflammatory drugs and colchicine were prescribed, but were ineffective. A closer clinical examination of the patient revealed pigmented papules on the palms, soles, oral mucosa, trunk, and genitals. Treponema pallidum hemagglutination assay and Venereal Disease Research Laboratory results were positive in the blood (titers 1: 32) and joint fluid. A computed tomography scan of the chest revealed a focal opacity in the lateral basal segment of the right lung. The diagnosis of secondary syphilis with mucocutaneous, articular, and pulmonary involvement was made. The evolution was favorable after a single intramuscular injection of benzathine-penicillin. Conclusions: Arthritis, mucocutaneous involvement, and lung lesions can be manifestations of secondary syphilis. A detailed anamnesis, clinical examination, serology, and imaging techniques are the pillars of diagnosing this condition.

show abstract

Section: Discussionsupporting

confidence: 70%