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[Sarcoidosis-like granulomatosis revealing a tertiary syphilis]
B Hervier1, H Wastiaux, T Freour
1Service de médecine interne, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex, France. baptiste.hervier@chu-nantes.fr
Abstract:
Numerous disorders can cause a systemic granulomatosis. We report a patient who presented a biopsy proven granulomatous skin eruption, fever, and atypical thoracic pain. Electrocardiogram showed a first-degree atrioventricular heart bloc. During follow-up he developed a panuveitis and oral corticosteroids were started. A diagnosis of systemic sarcoidosis was considered. Because of unfavourable ophthalmologic outcome, investigations were enlarged and revealed a highly positive serology for syphilis and VDRL both in serum and cerebrospinal fluid. Clinical outcome with penicillin G therapy was favorable. This observation reminds us the clinical polymorphism of syphilis, which can be presented as a systemic granulomatosis.
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