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[Syphilitic osteitis in an HIV-negative patient].

C Mignard1, N Litrowski1, D Carré1

  • 1Service de dermatologie, hôpital J.-Monod, groupe hospitalier du Havre, BP 24, 76083 Le Havre, France.

Annales De Dermatologie Et De Venereologie
|March 30, 2016
PubMed
Summary

Secondary syphilis can rarely affect bones, causing osteitis. This case highlights bone scintigraphy as key for diagnosing syphilitic osteitis in HIV-negative patients, with prolonged antibiotics as treatment.

Keywords:
Bone scintigraphyImmunocompetentImmunocompétentOsteitisOstéiteScintigraphie osseuseSecondary syphilisSyphilis secondaire

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Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Dermatology

Background:

  • Secondary syphilis is typically a systemic infection.
  • Skeletal involvement in secondary syphilis is exceptionally rare.
  • This report details a case in an HIV-negative individual.

Observation:

  • A 28-year-old HIV-negative homosexual male presented with persistent, severe headaches.
  • Symptoms persisted despite initial antibiotic treatment for secondary syphilis.
  • Bone scintigraphy identified three lesions indicative of syphilitic osteitis.

Findings:

  • Syphilitic osteitis is a rare manifestation of secondary syphilis.
  • Hematogenous spread of Treponema pallidum is the likely cause.
  • Febrile bone pain can suggest skeletal involvement.

Implications:

  • Bone scintigraphy is the optimal diagnostic modality for syphilitic osteitis.
  • Prolonged treatment with penicillin G or ceftriaxone is recommended.
  • Increased awareness is needed for rare skeletal manifestations of syphilis.