Secondary syphilis mimicking tuberculoid leprosy in an HIV-positive individual: a case report

Fernández‐Nieto, Diego; ­Ortega‐Quijano, ­Daniel; ­Jimenez‐Cauhe, Juan; Fernández-González, P.; Moreno-Moreno, Esther; Beá‐Ardébol, Sonia

doi:10.1177/0956462419869136

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Immunohistochemistry has better sensitivity and specificity than Warthin-Starry stain and thus can be widely used for secondary syphilis. 12,13 In the present case, we did not perform this staining because our serologic tests were positive for syphilis.…”

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confidence: 85%

Secondary Syphilis in a 12-Year-Old Girl Misdiagnosed as Pityriasis lichenoides et varioliformis acuta: A Case Report

Zhang

Huang

et al. 2021

CCID

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Syphilis is a complex, systemic infectious disease caused by Treponema pallidum subspecies pallidum. Herein, we report a rare case of secondary syphilis with probable neurosyphilis that was misdiagnosed as pityriasis lichenoides et varioliformis acuta (PLEVA) in a 12-year-old human immunodeficiency virus (HIV) negative patient. A female patient presented to our hospital with a four-month history of relapsed systemic rash, accompanied by hair loss, arthralgia and fatigue. Based on physical examination and skin biopsy, she was initially diagnosed as PLEVA and treated both locally and systemically but failed to present a dermatologic improvement. The diagnosis of secondary syphilis with probable neurosyphilis was made based on serologic and cerebrospinal fluid tests. After neurosyphilis therapy, the clinical manifestations of the patient were significantly improved. Physicians should be alert for the possibility of syphilis when encountering cases with unusual clinical manifestations.

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confidence: 85%

Secondary Syphilis in a 12-Year-Old Girl Misdiagnosed as Pityriasis lichenoides et varioliformis acuta: A Case Report

Zhang

Huang

et al. 2021

CCID

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“…3 Syphilis has varied clinical manifestations, serological and histopathological findings. 4 Coinfection of syphilis and HIV can alter the clinical course of the disease, notably mucocutaneous lesions, hasten disease development, complicate the diagnosis and raise the likelihood of additional organ problems and treatment failure with standard regimens. 5,6 In this article, we report a case of secondary syphilis in an HIV-positive patient with clinical features imitated mid-borderline leprosy.…”

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confidence: 99%

Secondary syphilis mimicking mid-borderline leprosy in HIV-positive patient

Putra

Hadi

2022

Bali Med J.

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Background: Syphilis increases the risk of HIV transmission. Coinfection of both infectious diseases potentially changes the presentation of mucocutaneous lesions and accelerates disease progression, complicating the diagnosis and treatment with standard regimens. In the case study, we present a case of secondary syphilis in an HIV-positive patient with clinical manifestations resembling mid-borderline leprosy. Case presentation: A 23-year-old male patient was referred to the emergency care unit of Dr. Soetomo General Hospital with red spots on the palms of the hands and soles of the feet for the past four months. The skin manifestation first appeared as a single spot, grew over time with itch and pain. The patient had lost 15 kg of body weight in the last three months which was confirmed as HIV-positive. He was also treated for leprosy based on the skin manifestations ever since. There was no history of direct contact with leprosy patients. The patient admitted that he had sex with men in the last 3-4 years. The laboratory examination showed negative results for Mycobacterium leprae through skin biopsy and negative for IgM and IgG of anti-phenolic glycolipid-1 (PGL-1). The patient however was positive for syphilis due to high titers of venereal disease research laboratory/rapid plasma regain (VDRL/RPR) and treponema pallidum hemagglutination (TPHA), supported by histological findings. The patient’s condition improved after receiving penicillin benzathine G, the definitive treatment for syphilis. Conclusion: Secondary syphilis is a great imitator to mid-borderline leprosy, especially in HIV patients. To avoid misdiagnosis and mistreatment, a careful physical and laboratory examination, including serology and histopathology, should be carried out.

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Concurrent pulmonary tuberculosis and lepromatous leprosy in a newly diagnosed HIV positive patient: a case report

et al. 2021

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Background The leprosy-tuberculosis (TB) co-infection is rarely reported in recent times. However, this dual comorbidity is associated with high mortality and major morbidity. Unrecognised leprosy-TB co-infection may predispose affected patients to rifampicin monotherapy and subsequent drug resistance. Case presentation A 35 year old migrant, human immunodeficiency virus (HIV) positive male worker presented with 6 month history of symmetric infiltrative nodular plaques of the face and distal, upper extremities. A few days after initial dermatology presentation, a sputum positive pulmonary tuberculosis diagnosis was made at his base hospital. Subsequent dermatology investigations revealed histology confirmed lepromatous leprosy and a weakly reactive rapid plasma reagin test. The presenting clinical features and laboratory results were suggestive of lepromatous leprosy coexisting with pulmonary tuberculosis in an HIV positive patient. Conclusions This case illustrates the occurrence of leprosy with pulmonary tuberculosis in an HIV infected patient and the difficulties in interpreting non-treponemal syphilis tests in these patients. This case also highlights the need for a high index of suspicion for co-infection and the need to exclude PTB prior to initiation of rifampicin containing multi-drug therapy (MDT). Interdisciplinary management and social support are crucial in these patients.

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Secondary syphilis mimicking tuberculoid leprosy in an HIV-positive individual: a case report

Cited by 4 publications

References 14 publications

Secondary Syphilis in a 12-Year-Old Girl Misdiagnosed as Pityriasis lichenoides et varioliformis acuta: A Case Report

Secondary Syphilis in a 12-Year-Old Girl Misdiagnosed as Pityriasis lichenoides et varioliformis acuta: A Case Report

Secondary syphilis mimicking mid-borderline leprosy in HIV-positive patient

Concurrent pulmonary tuberculosis and lepromatous leprosy in a newly diagnosed HIV positive patient: a case report

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