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Related Experiment Videos

[Tertiary syphilis with liver gummata].

W Fischbach1, J Mössner, J Dämmrich

  • 1Medizinische Poliklinik, Universität Würzburg.

Deutsche Medizinische Wochenschrift (1946)
|June 28, 1991
PubMed
Summary
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Tertiary syphilis can manifest as liver gummas, mimicking liver metastases. Early diagnosis and antibiotic treatment lead to complete recovery, highlighting syphilis as a crucial differential diagnosis for liver lesions.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Liver lesions often prompt investigation for malignancy, particularly liver metastases.
  • Nonspecific symptoms like fatigue and abdominal discomfort, coupled with elevated liver enzymes and cholestasis, can obscure the diagnosis.

Observation:

  • Sonography identified multiple echo-poor liver lesions in a patient presenting with nonspecific symptoms and cholestasis.
  • Initial investigations for a primary tumor and fine-needle biopsy were inconclusive.
  • Laparoscopic biopsy revealed gummas, indicative of tertiary syphilis.

Findings:

  • Biopsies confirmed hepatic gummas, leading to syphilis testing.
  • Serum revealed Treponema-specific IgM antibodies, confirming active syphilis.

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  • Antibiotic treatment (penicillin followed by erythromycin) resulted in complete normalization of liver function tests and regression of gummas.

    • Implications:

    • This case underscores the importance of considering syphilis in the differential diagnosis of unexplained liver space-occupying lesions.
    • Even in the modern era, syphilis remains a treatable cause of hepatic pathology.
    • Timely diagnosis and treatment of syphilitic liver disease can lead to excellent patient outcomes.