Rapid progression to gummatous tertiary syphilis in a patient with <scp>HIV</scp>

Charlton, Olivia; Puri, Prianka; Davey, Louella; Weatherall, Chris; Konecny, Pamela

doi:10.1111/ajd.12860

Cited by 9 publications

(9 citation statements)

References 11 publications

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“…[1][2][3][4] While the gumma represents a granulomatous inflammatory response to spirochetes, these are rare in gummas and Warthin-Starry staining may only identify few spirochetes if at all, making the diagnosis challenging. [5][6] We emphasize that syphilitic gumma should be considered in the differential of large nontender indurated oral lesions unresponsive to typical antibiotics for odontogenic infections, especially in a patient with concurrent STDs. [3] Coinfection with HIV is associated with rapid progression to tertiary syphilis as little as several months.…”

Section: Discussionmentioning

confidence: 99%

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Dental abscess as an initial presentation of tertiary syphilis: A case report

Carey¹,

Havranova²,

Le³

2018

ijmdcr

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Recognize syphilis as a re-emerging disease, especially in the presence of HIV. Syphilis, caused by the sexually transmitted spirochete Treponema pallidum, often occurs as coinfection in HIV-infected patients, and its prevalence has increased in the United States. We report a case of oral gummata presenting as a dental abscess in an HIVinfected 25-year-old MSM with no prior history of syphilis. The patient's rapid plasma reagin was positive at 1:512 dilution with positive confirmatory fluorescent treponemal antibody absorption test. Surgical exploration of the suspected abscess identified a 5-cm ulcerated mass eroding into the right maxillary sinus. Tissue gram stain and culture of the mass revealed only mixed oral flora. Pathology revealed acute and chronic inflammatory granulation tissue, and the Warthin-Starry stain identified rare microorganisms, suspicious for spirochetes. Our patient was treated for tertiary syphilis with intramuscular benzathine penicillin G injections weekly for 3 doses. At 1-month follow up, the patient was symptom-free.

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Section: Discussionmentioning

confidence: 99%

“…[3] Coinfection with HIV is associated with rapid progression to tertiary syphilis as little as several months. [5,6]…”

Section: Discussionmentioning

confidence: 99%

Dental abscess as an initial presentation of tertiary syphilis: A case report

Carey¹,

Havranova²,

Le³

2018

ijmdcr

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“…Syphilis can be divided into primary and secondary stage early syphilis (within one year of infection), and late latent and symptomatic syphilis [ 10 ]. The number of cases of late symptomatic syphilis have dropped significantly since the implementation of penicillin to treat early syphilis [ 11 ], but occasional cases of tertiary syphilis are still noted [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ,…”

Section: Introductionmentioning

confidence: 99%

Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

Jankowska

Adamski

Polańska

et al. 2022

IJERPH

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Tertiary syphilis is a large diagnostic challenge. It is rarely the case that it affects the skin, bone tissue and the eyes at the same time. The presented case shows that extensive symptomatology of syphilis poses a challenge in making a proper diagnosis in patients whose history does not suspect STDs. The study aims to present the case of a young woman hospitalized with a suspected autoimmune disease, diagnosed with symptomatic late syphilis with involvement of the skin, bones and eyes.

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“… Tertiary syphilis includes patients with late syphilis that show symptomatic manifestations. PLWH may progress to tertiary syphilis more rapidly than HIV-uninfected patients [32]. The more frequent forms are:  Cardiovascular syphilis classically involves the ascending thoracic aorta, resulting in a dilated aorta and aortic valve regurgitation.…”

mentioning

confidence: 99%

“… Tertiary syphilis includes patients with late syphilis that show symptomatic mani-Tertiary syphilis includes patients with late syphilis that show symptomatic manifestations. PLWH may progress to tertiary syphilis more rapidly than HIV-uninfected patients [32]. The more frequent forms are:…”

mentioning

confidence: 99%

A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines

et al. 2021

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In 2021 the scientific community's efforts have been focused on solving the back-breaking challenge of the COVID-19 pandemic, but sexually transmitted infections (STI) are still one of the most common global health problems. Syphilis is a systemic disease caused by the spirochaete Treponema pallidum (TP) and is one of the oldest known diseases. Its incidence has increased in the last few years and syphilis still remains a contemporary plague that continues to afflict millions of people worldwide. Despite research improvements, syphilis pathogenesis is not completely clear; clinical presentation is very heterogeneous and the diagnosis can sometimes be difficult. Furthermore, few therapeutic options are available, and a vaccine has not been found yet. In this review, we describe the most recent evidence concerning the clinical manifestation, diagnosis, treatment and vaccine prospectives for this disease.

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Rapid progression to gummatous tertiary syphilis in a patient with HIV

Abstract: Co-infection with human immunodeficiency virus-1 (HIV) and syphilis is associated with rapid progression to tertiary syphilis. This case report describes the early development of gummatous skin disease and suspected neurosyphilis in a patient with untreated HIV and approaches to treatment.

Cited by 9 publications

References 11 publications

Dental abscess as an initial presentation of tertiary syphilis: A case report

Dental abscess as an initial presentation of tertiary syphilis: A case report

Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines

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