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Syphilis: an unusual manifestation?
Shai Bezalely1, Giris Jacob1, Gideon Flusser2
1Department of Internal medicine 6, Sourasky Medical center, Tel Aviv, Israel.
BMJ Case Reports
|September 21, 2014
Summary
Early syphilis can present with bone pain and lytic lesions, symptoms typically seen in later stages. This case highlights the under-recognition of bone involvement in early-stage syphilis.
Area of Science:
- Infectious Diseases
- Dermatology
- Rheumatology
Background:
- Syphilis is a complex sexually transmitted infection with diverse clinical manifestations.
- It classically progresses through primary, secondary, latent, and tertiary stages.
- Atypical presentations, particularly in early syphilis, are increasingly reported.
Observation:
- A young adult male presented with a secondary syphilis rash and unusual bone pain.
- Radiographic examination revealed multiple lytic bone lesions, atypical for secondary syphilis.
- The patient responded well to treatment for secondary syphilis.
Findings:
- Bone pain and lytic lesions, typically associated with tertiary syphilis, can occur in the secondary stage.
- Early-stage syphilitic bone involvement may be more prevalent than previously recognized.
- This case underscores the diagnostic challenge posed by atypical syphilis presentations.
Implications:
- Increased clinical suspicion for early syphilis is warranted in patients presenting with bone pain and lytic lesions.
- Early diagnosis and treatment of syphilis can prevent long-term complications.
- Further research is needed to determine the true incidence of bone involvement in early syphilis.
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