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Syphilis Causing Lichenoid Esophagitis.

Shaheer Siddiqui1, Shruti Khurana1, Zhenjian Cai2

  • 1Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, TX.

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|July 9, 2020
PubMed
Summary
This summary is machine-generated.

A rare case of esophageal syphilis presenting as lichenoid esophagitis was found in an HIV-positive woman with gastrointestinal bleeding. This extremely rare presentation of Treponema pallidum infection in the esophagus has not been previously reported.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pathology

Background:

  • Human immunodeficiency virus (HIV) infection can predispose individuals to various opportunistic infections and gastrointestinal complications.
  • Upper gastrointestinal bleeding, characterized by melenic stools, necessitates thorough endoscopic evaluation.

Observation:

  • A 50-year-old woman with HIV presented with melenic stools and anemia, prompting an esophagogastroduodenoscopy.
  • Endoscopic findings revealed esophageal inflammation with ulcerations and crater formation.

Findings:

  • Biopsy analysis demonstrated severe inflammation with lymphocytic infiltrates and Civatte bodies, indicative of lichenoid esophagitis.
  • Spirochetes, identified as *Treponema pallidum*, were present, confirming esophageal syphilis.

Implications:

  • This case represents the first reported instance of esophageal syphilis manifesting as lichenoid esophagitis.
  • The findings highlight the importance of considering syphilis in the differential diagnosis of esophageal pathology, particularly in immunocompromised patients.