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Syphilitic pneumonia: case report and systematic review.
Giuseppe Pipitone1, Michelle Abbott1, Andrea Gizzi1
1Infectious Disease Unit, ARNAS Civico-Di Cristina, Palermo, Italy.
Syphilitic pneumonia, a rare infection by Treponema pallidum, often presents as nodular lung lesions. Clinicians should consider this presentation, especially in patients with secondary syphilis.
Area of Science:
- Infectious Diseases
- Pulmonology
- Dermatology
Background:
- Syphilitic pneumonia is an uncommon manifestation of secondary syphilis caused by Treponema pallidum.
- This study investigates syphilitic pneumonia, particularly in individuals with Human Immunodeficiency Virus (HIV).
Observation:
- A case of syphilitic pneumonia in an HIV-positive patient with controlled infection is presented.
- A systematic literature review identified 43 historical cases, adding the current case for analysis (total 44).
- The majority of patients (91%) were male, with a median age of 46.
Findings:
- Among analyzed cases, 32% were people living with HIV.
- Syphilis-related hepatitis was observed in 63% of patients.
- Maculopapular rash, indicative of secondary syphilis, was present in 66.6% of patients.
- Nodular lesions on chest imaging (X-ray or CT scan) were found in 74.4% of patients.
Implications:
- The high prevalence of nodular lung lesions suggests it is a common presentation of syphilitic pneumonia.
- Clinicians should include syphilitic pneumonia in the differential diagnosis for patients presenting with nodular pneumonia.
- Early recognition and treatment are crucial for managing this rare but significant syphilitic complication.
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