Thirty-Two-Year-Old Man With Osteolytic Skull Lesion

Alraddadi, Basem; Alrakawi, Salah; Stone, David D.

doi:10.1097/01.olq.0000431350.42722.81

Cited by 4 publications

(5 citation statements)

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“…In 1952, another radiologic survey found seven cases (9%) of skull involvement in 80 patients with secondary syphilis [ 46 ]. An increasing trend of bone involvement in syphilis was found in recent studies [ 3 , 4 , 30 , 47 – 55 ]. Some experts demonstrated that the incidence of syphilis-caused destructive bone lesions in previous survey may be underestimated [ 26 ].…”

Section: Discussionmentioning

confidence: 67%

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The disappearance of femoral head and neck resulting from extensive bone defect caused by secondary syphilis: a case report and literature review

Liang

Yuan

Wang

et al. 2018

BMC Musculoskelet Disord

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BackgroundTreponema Pallidum (TP), the pathogen of syphilis, commonly infects bones in cases of congenital and tertiary syphilis, but it is rare in the primary and secondary stages. With its mild symptoms and rare clinical findings, it might be easy to dismiss the diagnosis of early syphilis. Usually, effective results can be achieved after the conventional strategy of antibiotic treatments, mainly penicillin. To our knowledge, our case is so far the most serious reported case of destructive bone lesion in secondary syphilis, and our treatment for the case is the first strategy using total hip arthroplasty in secondary syphilis.Case presentationWe present the case of a 71-year-old man with local repeated pain and dysfunction in the right hip. Radiologic examinations showed the disappearance of the ipsilateral femoral head and neck. After excluding the aetiologies of cancer metastasis and tuberculosis, we confirmed the diagnosis of syphilitic arthritis. The patient received the medical treatment of antibiotics and the surgical treatment of total hip arthroplasty. At the follow-up of 1, 3, and 5.5 years after the operation, the patient presented with a pain-free and functional hip prosthesis without local signs of infection and loosening.ConclusionsThis report highlights the difficulties of early diagnosis of secondary syphilis with bone involvement. Bone defect of the femur with secondary syphilis, especially at the proximal femur, was an extremely rare complication in the previous reports. Our case was the first case of a patient who experienced the disappearance of femoral head and neck caused by secondary syphilis. Follow-up after the operation proved the successful treatment of the extensive bone defect of femur by total hip arthroplasty.

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Section: Discussionmentioning

confidence: 67%

“…Bone lesions in syphilis are mainly involved in the skull, tibia, sternum, clavicle and rib [ 3 , 5 , 26 , 55 – 57 ]. Our retrospective analysis also verifies that the tibia is the most frequently affected long bone in the limbs.…”

Section: Discussionmentioning

confidence: 99%

The disappearance of femoral head and neck resulting from extensive bone defect caused by secondary syphilis: a case report and literature review

Liang

Yuan

Wang

et al. 2018

BMC Musculoskelet Disord

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“…6,7 Symptoms may include headaches (when the skull is involved). 8 Given the rarity of such lesions, there is no established therapeutic regimen, but literature suggests 2.4 million units of IM BP-G weekly for 2-4 weeks as a consensus approach. 6 The absence of T. pallidum in liver biopsy samples may result from early treatment before the biopsy was performed and the infrequent presence of spirochetes per se.…”

Section: Hepatic Inflammatory Pseudotumours Mimicking Metastatic Dise...mentioning

confidence: 99%

Hepatic inflammatory pseudotumours mimicking metastatic disease in a non‐HIV patient with secondary syphilis

Planella‐Fontanillas,

Rial‐Villavecchia,

Villar‐García

et al. 2024

Acad Dermatol Venereol

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Interphase between preserved liver parenchyma (showing oedema and an acute and chronic portal inflammatory infiltrate with eosinophils) and inflammatory pseudotumor of the liver (IPL) (chronic inflammatory infiltrate, made up of small lymphoid cells, plasma cells and granulomatous inflammation with poorly constituted non-necrotizing granulomas and fibroblastic cells). Panel (b): H/E ×40: chronic inflammation consisting of a mixed infiltrate with predominance of plasma cells (black arrow heads).

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“…Although only one report about this issue has been documented in Korea, 6 other similar reports are available from other countries. [7][8][9][10][11][12][13][14][15][16] Bone pain is the most common complaint, which is aggravated during the night and upon exposure to heat and pressure. Involvement of the skull can lead to headache, usually in the frontotemporal area.…”

Section: Bone Involvementmentioning

confidence: 99%

“…Involvement of the skull can lead to headache, usually in the frontotemporal area. [6][7][8][9][10][11][12][13][14][15][16] Prompt resolution of bone pain after penicillin therapy is evidence of a syphilitic cause for the bone lesions. A diagnosis of early syphilis is suspected based on the mucocutaneous findings in 76% of patients.…”

Section: Bone Involvementmentioning

confidence: 99%