Erythema multiforme triggered by Treponema pallidum infection in an HIV-infected patient

2017 ◽  
Vol 29 (1) ◽  
pp. 99-102 ◽  
Author(s):  
Luiz GFAB D’Elia Zanella ◽  
Érika F Sampaio ◽  
Rute F Lellis
Keyword(s):  
Erythema Multiforme ◽  
Infected Patient ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Daily Practice ◽  
Secondary Syphilis ◽  
Positive Patient ◽  
Hiv Positive ◽  
Clinical Conditions

We are currently facing a worldwide epidemic of syphilis. Clinical manifestations that are rarely seen have been encountered, leading the dermatologist to confront unusual clinical conditions in daily practice. Erythema multiforme triggered by syphilis is very rare and is also seldom reported in the literature. We report a case of secondary syphilis in an HIV-positive patient, whose clinical, pathologic and serologic features were consistent with the diagnosis of erythema multiforme triggered by syphilis.

scholarly journals Salmonella enterica subsp houtenae serogroup O:16 in a HIV positive patient: case report

2004 ◽  
Vol 46 (3) ◽  
pp. 169-170 ◽  
Author(s):  
Maria Cristina S. Lourenço ◽  
Eliane Falavina M. dos Reis ◽  
Rogério Valls ◽  
Marise Dutra Asensi ◽  
Ernesto Hofer
Keyword(s):  
Case Report ◽  
Blood Culture ◽  
Physical Examination ◽  
Salmonella Enterica ◽  
Infected Patient ◽  
Leukocyte Count ◽  
Positive Patient ◽  
Hiv Positive ◽  
Patient Case ◽  
Retrosternal Pain

We described a case of salmonellosis in a 33-year old HIV-infected patient. The patient presented oral and esophageal candidiasis, intense epigastric and retrosternal pain. During the physical examination he was hypochloraemic, acyanotic, hypohydrated, anicteric and afebrile. Admittance laboratorial tests indicated: red cells 3.6 millions/mm³; hemoglobin, 10.1 g/dL; leukocyte count, 3,000/mm³, with 1% of eosinophils, 14% of non-segmented and 53% of segmented neutrophils and 31% of lymphocytes. The blood culture was positive for Salmonella enterica subsp houtenae serogroup O:16. This is probably the first human report of bacteremia due to Salmonella enterica subsp houtenae in Brazil associated to HIV-infected patient.

scholarly journals Beyond appearance: An unusual manifestation of isolated oral secondary syphilis

2019 ◽  
Vol 33 ◽  
pp. 205873841984556
Author(s):  
Elena Mari ◽  
Maurizio Nudo ◽  
Enzo Palese ◽  
Luisa Cotticelli ◽  
Ciro Cotticelli ◽  
...  
Keyword(s):  
Chronic Infection ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Secondary Syphilis ◽  
Unusual Manifestation ◽  
Oral Manifestation ◽  
Secondary Stage ◽  
Recurrent Activity ◽  
Systemic Manifestations ◽  
Mucosal Lesions

Syphilis is a sexually acquired chronic infection caused by Treponema pallidum and is characterized by a variety of clinical manifestations. The secondary stage of the disease results from the hematogenous and lymphatic dissemination of treponemes after a few weeks or months, and it is characterized by recurrent activity of the disease, with muco-cutaneous as well as systemic manifestations. Mucosal lesions range from small, superficial ulcers that resemble painless aphthae to large gray plaques, and they are generally associated with systemic manifestations of the disease. The exclusive asymptomatic oral localization not associated with general manifestations is uncommon but may actually be unrecognized and under-reported. We report a case of isolated oral manifestation as the unique presentation of secondary syphilis.

scholarly journals Evaluation of the Determine Rapid Syphilis TP Assay Using Sera

2004 ◽  
Vol 11 (1) ◽  
pp. 98-101 ◽  
Author(s):  
Theresa Diaz ◽  
Maria de Gloria Bonecini Almeida ◽  
Ingebourg Georg ◽  
Suely de Carvalho Maia ◽  
Rogerio Valls de Souza ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Treponema Pallidum ◽  
High Sensitivity ◽  
Hiv Positive ◽  
Hemagglutination Assay ◽  
Laboratory Facilities ◽  
Immunodeficiency Virus ◽  
Resource Poor ◽  
Clinical Conditions ◽  
Hiv Negative

ABSTRACT The Abbott Determine Rapid Syphilis TP assay is a treponemal test that can be used in resource-poor settings that lack laboratory facilities. However, this test has not been extensively evaluated. We measured its sensitivity and specificity by using stored serum specimens (n = 567) from all persons who tested Treponema pallidum hemagglutination assay (TPHA) positive (n = 250) or TPHA indeterminate (n = 17) in the year 2001 and the first 300 patients in 2001 who tested TPHA negative at the Evandro Chagas Research Institute in Rio de Janeiro, Brazil. This rapid assay was independently interpreted by three different observers. With TPHA results as the reference, sensitivity ranged between readers from 95.6 to 98.4% and specificity ranged from 97.3 to 95.7%. There was little interreader variability in the interpretation of results, with approximately 98% agreement for all reader combinations. Of samples from persons with human immunodeficiency virus (HIV) infection (n = 198), sensitivity was 96.9 to 99.2% and it was 94.4 to 96.3% among HIV-negative persons (n = 127). Specificity was 92.4 to 95.5% among HIV-positive persons and 97.2 to 100% among HIV-negative persons. We found this test to have high sensitivity and specificity and little interreader variability, indicating that it may be easily used in resource-poor settings without laboratory facilities. Further studies are needed using this test on whole blood and under the clinical conditions for which it is intended.

scholarly journals Secondary Syphilis in Human Immunodeficiency Virus (HIV)-Infected Men Who Have Sex with Men (MSM): A Case Report

2020 ◽  
Vol 32 (1) ◽  
pp. 75
Author(s):  
Ade Fernandes ◽  
Evy Ervianti
Keyword(s):  
Human Immunodeficiency Virus ◽  
Treatment Success ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Secondary Syphilis ◽  
Response To Treatment ◽  
Immunodeficiency Virus ◽  
Tertiary Stage ◽  
Sex With Men

Background: Recently, the incidence of syphilis among men who have sex with men (MSM) has increased rapidly, especially among Human Immunodeficiency Virus (HIV)-infected MSM. Coinfection with these two organisms alter the symptoms and signs, progression of the disease, and the risk of progressing to the tertiary stage. Purpose: To report a case of secondary syphilis in HIV-infected MSM.  Case: A 24-year-old male complaint of multiple redness macule for 1-month duration on his chest, back, groin, palm, and soles. The rash was neither painful nor pruritic. He also complains of hair loss resulting "moth eaten" alopecia. One month before, he had a painless ulcer on his genital, which resolved without treatment. His HIV infection was diagnosed two years earlier. He had been sexually active with multiple homosexual partners without using a condom since 2010. The Venereal Disease Research Laboratory test (VDRL) titer was 1/32, and Treponema pallidum haemagglutination assay (TPHA) was 1/20480. Initial treatment was a single dose of 2.4 million units of benzathine penicillin. Serologic examination was reevaluated on month 1, 3, 6, and 9 after therapy and declined in the third month. Discussion: For HIV-infected persons, the clinical manifestations of syphilis in most of the cases remain the same. However, the lesions are more aggressive, and coexistence of primary and secondary syphilis is more frequent. Serologic tests are accurate and reliable for the diagnosis and for following a patient’s response to treatment. Penicillin is effective but physical and serological follow up is needed. Conclusion: HIV-infected MSM have higher risk of syphilis. Staging is needed to determine the treatment. Serologic examination should be repeated and long enough to monitor the treatment success.

scholarly journals Essential syphilitic alopecia: Non-scarring alopecia in 21-year-old man

2021 ◽  
Vol 12 (e) ◽  
pp. 1-3
Author(s):  
Hafssa Chehab ◽  
Bertrand Richert
Keyword(s):  
Hair Loss ◽  
Previous History ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Laboratory Evaluation ◽  
History Of ◽  
High Level

ABSTRACT Alopecia syphilitica is a less common clinical manifestations of secondary syphilis. It is uncommon for hair loss to be the sole or predominant manifestation, as hair loss is the chief clinical and histologic differential diagnosis of. The main difference between alopecia areata and Alopecia syphilitica is the detection of Treponema pallidum in syphilis. We present the case of a 21- year-old belgium man with different patches of non-cicatricial alopecia of his scalp. The patient denied previous history of genital or other skin lesions. Laboratory evaluation was positive for syphilis. The diagnosis of alopecia syphilitica was made and he was treated with single intramuscular injections of benzathine penicillin. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.

Cholangitis and pulmonary nodules in a clinical presentation of syphilis in an HIV-infected patient

2019 ◽  
Vol 30 (8) ◽  
pp. 820-824
Author(s):  
Evelyn Hermida-Lama ◽  
Javier Marco-Hernández ◽  
Alice Annalisa Medaglia ◽  
Mario Pagès ◽  
Ivan Vollmer ◽  
...  
Keyword(s):  
Liver Disease ◽  
Magnetic Resonance ◽  
Infected Patient ◽  
Clinical Presentation ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Pulmonary Nodules ◽  
Drug Induced ◽  
Liver Biopsies ◽  
Sex With Men

Several clinical manifestations attributed to syphilitic infection have been described in the literature. This is important because of the increased incidence of this infection mainly among men who have sex with men. We report the case of an HIV-infected patient who was hospitalized due to severe cholestasis, initially interpreted as drug-induced liver disease. It evolved slowly, with increasing intrahepatic cholangitis confirmed by magnetic resonance cholangiography and the appearance of several pulmonary nodules. In lung and liver biopsies, the presence of Treponema pallidum was detected by molecular and immunohistochemistry techniques, and a diagnosis of cholangitis and pulmonary syphilis was made.

Secondary syphilis presenting as erythema multiforme in a HIV-positive homosexual man: a case report and literature review

2018 ◽  
Vol 30 (3) ◽  
pp. 304-309
Author(s):  
Hongfang Liu ◽  
Beng-Tin Goh ◽  
Taoyuan Huang ◽  
Yinghui Liu ◽  
Ruzeng Xue ◽  
...  
Keyword(s):  
Plasma Cell ◽  
Erythema Multiforme ◽  
Treponema Pallidum ◽  
Inflammatory Cells ◽  
Secondary Syphilis ◽  
Penicillin G ◽  
Cell Infiltrate ◽  
Early Syphilis ◽  
Skin Histology ◽  
Anal Warts

Early syphilis can rarely cause erythema multiforme-type eruptions as well as triggering erythema multiforme (EM). EM-like lesions in secondary syphilis are characterized by clinical features of EM and laboratory tests consistent with secondary syphilis and the skin histology shows predominantly a plasma cell infiltrate with the presence of treponemes. When EM is triggered by early syphilis, the skin histology shows mixed inflammatory cells usually in the absence of treponemes in the skin lesion. There may also be mixed histology with the presence of treponemes in the absence of a plasma cell infiltrate and vice versa. We describe a case of secondary syphilis presenting as EM with bullae and histology showing EM features without a plasma cell infiltrate but positive for Treponema pallidum by immunohistochemical staining. The patient was also coinfected with cytomegalovirus, human immunodeficiency virus, and anal warts. The EM eruptions resolved with treatment for secondary syphilis with benzathine penicillin G.

Stevens Johnson Syndrome versus Jarisch Herxheimer Reaction in an HIV Positive Patient with Secondary Syphilis

2017 ◽  
Vol 11 (2) ◽  
Author(s):  
Sarah Micozzi ◽  
Patricia Rojas Perez-Ezquerra ◽  
Cristina Morales-Cabeza ◽  
Cristina Diez ◽  
Manuel De Barrio
Keyword(s):  
Secondary Syphilis ◽  
Positive Patient ◽  
Stevens Johnson Syndrome ◽  
Hiv Positive ◽  
Johnson Syndrome
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