Acquired syphilis in a patient with late congenital syphilis

Late congenital syphilis was diagnosed in a 22-year-old woman on the basis of clinical, serologic and epidemiologic features. Clinical examination showed the "saddle-nose" deformity, Hutchinson's teeth, high-arched palate, Dubois little-finger sign, and small maxillae resulting in shallow depression of the central part of the face. Two years after receiving adequate treatment for late congenital syphilis, she presented with a primary syphilitic chancre; thus it was concluded that the woman had no immunity to reinfection with Treponema pallidum.