Pulmonary Involvement in Secondary Syphilis

In secondary syphilis, Treponema pallidum can spread to the lungs. A new case is described of a patient with multiple excavated subpleural pulmonary nodules, a rare localization of secondary syphilis. Despite the numerous pulmonary samples analysed in the literature, T. pallidum is rarely visualised directly on bronchial fibroscopy or biopsy. The diagnosis of secondary syphilis is suspected from historical and physical findings and confirmed by high values obtained from non-treponemal tests.

The clinical and radiological presentation of pulmonary involvement in secondary syphilis is non-specific, described as solitary or multiple subpleural nodular opacities that are rarely infiltrating.We confirm here that for this localization, biopsy of these nodules is not necessary for diagnosis.