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[Complicated syphilis therapy by permanent fillers].

Jeannine Zader1, Manfred Kunz2, Jan C Simon2

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Summary

Rising syphilis cases in Germany primarily affect men who have sex with men. Cosmetic fillers in an HIV-positive patient necessitated alternative intravenous ceftriaxone treatment due to intramuscular penicillin administration challenges.

Keywords:
Adverse eventsCeftriaxonePenicillinPolymethyl methacrylateSexually transmitted diseases

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Public Health

Background:

  • Sexually transmitted diseases (STDs), particularly syphilis, are increasing in Germany.
  • Men who have sex with men (MSM) represent the predominant demographic affected by this rise.
  • HIV-positive individuals present unique challenges in STD management.

Purpose of the Study:

  • To report a challenging case of syphilis management in an HIV-positive patient.
  • To highlight the impact of cosmetic procedures on standard STD treatment protocols.
  • To discuss alternative therapeutic strategies when standard treatment is contraindicated.

Main Methods:

  • Case report of an HIV-positive patient diagnosed with syphilis.
  • Evaluation of treatment options considering the presence of permanent cosmetic fillers.
  • Administration of intravenous ceftriaxone as an alternative to intramuscular penicillin.

Main Results:

  • Standard intramuscular penicillin therapy for syphilis was not feasible due to cosmetic buttock and thigh fillers.
  • Intravenous ceftriaxone was successfully administered according to current treatment guidelines.
  • The patient's syphilis was managed effectively with the alternative intravenous regimen.

Conclusions:

  • Cosmetic filler implantation can complicate standard syphilis treatment protocols, especially intramuscular injections.
  • Intravenous ceftriaxone is a viable alternative for syphilis treatment in cases where intramuscular administration is not possible.
  • Adherence to current guidelines is crucial for managing STDs in complex patient scenarios.