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Gastric Syphilis Mimicking Lymphoma: A Case Report
Jiafei Cao1,2, Jian Zhu3, Yining Xiang4
1Department of Gastroenterology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, People's Republic of China.
Infection and Drug Resistance
|July 17, 2023
Summary
Gastric syphilis, a rare condition, often presents with non-specific symptoms, mimicking other diseases. This case highlights the importance of considering syphilis in differential diagnoses for unexplained gastric issues.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Gastric syphilis is an uncommon manifestation of syphilis, affecting approximately 1% of cases.
- Its non-specific signs and symptoms frequently lead to diagnostic challenges and delays.
- Early recognition is crucial for effective management and preventing complications.
Observation:
- A 28-year-old woman presented with epigastric pain, nausea, vomiting, hematemesis, alopecia, and weight loss.
- Initial tests revealed co-infection with Helicobacter pylori, alongside positive syphilis serology (RPR 1:128, TPPA 1:320).
- Imaging and gastroscopy showed gastric wall thickening, antral exudation, lymphadenopathy, and irregular ulcers, initially suggestive of lymphoma.
Findings:
- Biopsy results excluded lymphoma, but immunohistochemistry confirmed abundant syphilis spirochetes in gastric tissues.
- This confirmed the diagnosis of gastric syphilis.
- The patient's co-infection with H. pylori was also noted.
Implications:
- This case underscores the importance of including gastric syphilis in the differential diagnosis for patients with unexplained gastrointestinal symptoms and relevant serological findings.
- Prompt diagnosis and appropriate treatment for syphilis, alongside management of co-infections like H. pylori, are essential for favorable outcomes.
- Highlighting the diagnostic mimicry of gastric syphilis, particularly with conditions like lymphoma, aids clinicians in refining diagnostic strategies.
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