[Syphilitic osteitis in an HIV-negative patient]

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.