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Early malignant syphilis observed during infection and reinfection in the same patient
Abstract:
Malignant syphilitic infections occurring in the same woman at an interval of 38 months is reported. The first infection was diagnosed as secondary papulopustular and ecthymatous syphilis. The reinfection was more severe, taking the form of secondary ulcerative syphilis with fever, general deterioration, and loss of weight. Numerous Treponema pallidum were present in the serum expressed from the papulopustular lesions during the first infection, but they were absent from the secretion expressed from the margins of the ulcerative symphilides during the reinfection. Many treponemes were present in the plasma cell infiltrates in histopathological sections of the biopsy specimens taken from the margin of the ulcers.
Insights
This case report details a woman experiencing two distinct malignant syphilis infections over 38 months. The second infection was more severe, presenting with ulcerative lesions despite Treponema pallidum absence in external secretions.
Area of Science:
- Infectious Diseases
- Dermatology
- Pathology
Background:
- Syphilis is a sexually transmitted infection caused by Treponema pallidum.
- Malignant syphilis is a rare, severe form of secondary syphilis.
- Recurrent syphilis infections can occur, sometimes with varying clinical presentations.
Observation:
- A single patient presented with two separate episodes of malignant syphilis 38 months apart.
- The initial infection manifested as papulopustular and ecthymatous syphilis.
- The recurrent infection was more severe, characterized by ulcerative syphilis with systemic symptoms like fever and weight loss.
Findings:
- Treponema pallidum was abundant in serum from lesions during the first infection.
- During the second infection, T. pallidum was not detected in secretions from ulcerative lesions.
- Histopathological examination revealed numerous treponemes within plasma cell infiltrates at the ulcer margins of the recurrent infection.
Implications:
- This case highlights the potential for severe recurrent syphilis infections.
- It underscores the importance of histopathological analysis for diagnosing syphilis when treponemes are not readily found in surface exudates.
- Understanding the varied clinical and microbiological presentations of recurrent syphilis is crucial for effective patient management.