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Syphilis presenting as isolated cervical lymphadenopathy: two related cases
Reinout van Crevel1, Johanna M M Grefte, Damiaen van Doorninck
1Department of Internal Medicine, Radboud University Nijmegen Medical Center, Geert Grooteplein 8, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. r.vancrevel@aig.umcn.nl
The Journal of Infection
|July 25, 2008
Summary
Unexplained cervical lymphadenitis in young adults may indicate syphilis. Early diagnosis is crucial, even without typical risk factors for sexually transmitted infections (STI).
Area of Science:
- Infectious Diseases
- Dermatology
- Otolaryngology
Background:
- Sexually transmitted infections (STI) are a significant global health concern.
- Cervical lymphadenitis is a common clinical presentation, often associated with various infectious and non-infectious etiologies.
- Syphilis, a curable bacterial infection, can manifest with diverse clinical symptoms, including lymphadenopathy.
Observation:
- Two young adult brothers presented with unilateral cervical lymphadenitis.
- Neither patient had apparent risk factors for sexually transmitted infections (STI).
Findings:
- Syphilis was diagnosed in both cases.
- Diagnosis was confirmed by fine-needle aspiration cytology in one brother.
- Serology and lymph node biopsy confirmed syphilis in the second brother.
Implications:
- Clinicians should maintain a high index of suspicion for syphilis in patients with unexplained cervical lymphadenitis.
- A low diagnostic threshold for syphilis testing is warranted, irrespective of perceived STI risk or history of primary syphilis.
- Early diagnosis and treatment of syphilis are essential to prevent long-term complications.
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