Syphilitic hepatitis resulting in fulminant hepatic failure requiring liver transplantation

Syphilitic hepatitis is a rare but well described syndrome, typically manifesting as a mild clinical hepatitis, with complete resolution following therapy. There have been several cases of severe hepatitis, but none progressing to a fatal outcome. We present a case of fulminant hepatitis and hepatic failure in the setting of active secondary syphilis resulting in liver transplantation. The clinical syndrome of syphilitic hepatitis is discussed. This case should highlight and remind physicians of the varied and severe manifestations of syphilis, and prompt physicians to explore syphilis as a possible cause of unexplained hepatitis.