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Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
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The bm12 Inducible Model of Systemic Lupus Erythematosus SLE in C57BL/6 Mice
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Lupus or syphilis? That is the question!

Joana Azevedo Duarte1, Celia Coelho Henriques2, Carolina Sousa3

  • 1Department of Internal Medicina IV, Fernando Fonseca Hospital, Amadora, Portugal.

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Summary

This case study highlights a rare presentation of systemic lupus erythematosus (SLE) mimicking secondary syphilis. The patient, initially diagnosed with syphilis, showed significant improvement in neurological symptoms after SLE treatment.

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Area of Science:

  • Internal Medicine
  • Neurology
  • Rheumatology
  • Infectious Diseases

Background:

  • Systemic lupus erythematosus (SLE) can manifest with diverse neurological symptoms, sometimes complicating diagnosis.
  • Secondary syphilis shares mucocutaneous and neurological signs with other systemic diseases, posing a diagnostic challenge.
  • Transverse myelitis is a rare but serious neurological complication of SLE.

Observation:

  • A 47-year-old male presented with a month of fever, rash on palms and soles, weakness, weight loss, incontinence, urinary retention, and confusion.
  • Neurological exam revealed paraparesis and distal hypoesthesia.
  • Laboratory results showed positive VDRL and TPHA titers, indicating syphilis, alongside positive antinuclear antibodies and nephrotic proteinuria, suggesting SLE.

Findings:

  • Cerebrospinal fluid analysis excluded neurosyphilis.
  • A dual diagnosis of secondary syphilis and systemic lupus erythematosus was established.
  • The patient's transverse myelitis, a rare SLE manifestation, showed improvement with immunosuppressive therapy (cyclophosphamide, corticosteroids, hydroxychloroquine) and penicillin G for syphilis.

Implications:

  • This case underscores the importance of considering both infectious and autoimmune etiologies in patients with overlapping symptoms.
  • Early recognition and combined treatment of syphilis and SLE are crucial for managing complex neurological presentations.
  • Highlighting rare SLE manifestations like transverse myelitis is vital for diagnostic awareness and therapeutic strategies.