Atypical Presentation of Syphilis With a Superimposed Methicillin-Resistant Staphylococcus aureus Infection

Syphilis, caused by the organism Treponema pallidum, is a sexually transmitted infection that typically presents with a painless ulcer on the genitalia or oral mucosa. Primary syphilitic ulcers can go unnoticed and progress to more serious presentations, including disseminated cutaneous disease, neurologic disease, and even death. Early recognition and treatment can resolve the infection. Some infections are complicated by abnormal presentations or masked by additional infections. Risk factors for presentation variances include undomiciled persons or people who regularly participate in high-risk sexual activities. We present a case of disseminated syphilis with superimposed superficial methicillin-resistant Staphylococcus aureus infection in an immunocompetent patient with a history of homelessness and IV drug use.