Late Hepatic Syphilis

Kellock, Ian A.; Laird, S. M.

doi:10.1136/sti.32.4.236

Cited by 2 publications

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“…Liver biopsy for our patient was suggestive of mixed inflammation with patchy necrosis and negative for granulomas and spirochetes (Figure 2). Other cases reported granulomas and inflammatory cells in portal tracts and hepatic lobules [3][4][5][6][7][8]. Our case presented a patient with primarily dermatologic complaints whose evaluation led to the diagnosis of syphilitic hepatitis.…”

Section: Table 1: Comparison Of Patients Described In Referenced Case...mentioning

confidence: 81%

“…While hepatitis remains an uncommon manifestation of syphilis, hepatic involvement has been a known sequela since 1585, as described by Paracelsus [ 3 ]. Kellock and Laird noted in 1956 that the diagnosis was predominantly clinical and supported by positive serological evidence, response to treatment, and lack of evidence for alternate etiologies [ 5 ]. These early observations are reflected in the criteria outlined by Mullick et al in 2004 [ 3 ]: (1) abnormal liver function tests (LFTs); (2) positive syphilis serologies (RPR and fluorescent treponemal antibody absorption [FTA-Abs] or microhemagglutination assay for Treponema pallidum antibodies [MHA-TP]); (3) evidence to rule out other etiologies of hepatic injury and (4) clinical improvement of LFTs following initiation of pharmacologic therapy.…”

Section: Discussionmentioning

confidence: 99%

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When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Dawson¹,

Zhang²,

Salahi³

et al. 2022

Cureus

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Secondary syphilis has variable systemic manifestations, impersonating the presentation of more common pathologies, deceiving clinicians, and creating a difficult-to-diagnose patient. The case discussed combines hepatic syphilis with an uncommon syphilitic dermatologic presentation in a patient with HIV and a history of hepatitis A and B. Due to the challenge of diagnosis, the relative ease of confirming the diagnosis with serological assays, and reversibility of hepatic injury, the inclusion of syphilitic hepatitis on a differential diagnosis of hepatitis is warranted.

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Section: Table 1: Comparison Of Patients Described In Referenced Case...mentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Dawson¹,

Zhang²,

Salahi³

et al. 2022

Cureus

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Maincent

Labadie²,

Fabrè³

et al. 1997

Digestive Diseases and Sciences

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Although the incidence of syphilis is increasing, liver involvement in tertiary syphilis remains exceptional. We report a case of tertiary syphilis revealed by liver localization. The clinical picture was misleading, mimicking multinodular hepatic metastasis. The final diagnosis was suspected following a fine-needle ultrasound-guided biopsy of a liver nodule showing granulomas as well as acellular necrosis and confirmed by positive serum syphilitic reactions and the presence of spirochetes in the liver. The outcome was uneventful following antibiotic treatment. It is important to be aware of the misleading picture of the disease, which has a favorable prognosis provided that simple treatment is rapidly initiated.

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Late Hepatic Syphilis

Cited by 2 publications

References 6 publications

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

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