Luetic lymphadenitis: solving the secretive swell

Area of Science:

• Infectious Diseases
• Oncology
• Dermatology

Background:

• Syphilis presents with diverse clinical manifestations, frequently mimicking other conditions.
• Secondary syphilis can uncommonly cause generalized lymphadenopathy, leading to misdiagnosis as lymphoproliferative disorders.
• Diagnostic challenges arise due to syphilis's varied presentations, necessitating a broad differential diagnosis.

Purpose of the Study:

• To highlight a rare presentation of secondary syphilis mimicking lymphoproliferative disorders.
• To emphasize the importance of a comprehensive sexual history in diagnosing syphilis.
• To underscore the need for considering syphilis in patients with unexplained lymphadenopathy and hepatosplenomegaly.

Main Methods:

• Case report of a male patient in his late 20s presenting with lymphadenopathy and hepatosplenomegaly.
• Initial investigations included imaging and biopsy, which suggested dermatopathic lymphadenopathy.
• Diagnosis was confirmed through a detailed sexual history, followed by treatment with benzathine penicillin.

Main Results:

• The patient presented with symptoms suggestive of a lymphoproliferative disorder, including appetite loss, lymphadenopathy, and hepatosplenomegaly.
• Biopsy results initially indicated dermatopathic lymphadenopathy, delaying the diagnosis of syphilis.
• Treatment with benzathine penicillin led to complete resolution of symptoms and lymphadenopathy.

Conclusions:

• Syphilis should be considered in the differential diagnosis of generalized lymphadenopathy and hepatosplenomegaly, even in the absence of typical cutaneous manifestations.
• Incomplete sexual history can lead to diagnostic delays, underscoring the need for thorough patient evaluation.
• Early diagnosis and appropriate treatment of syphilis are essential for favorable patient outcomes and preventing complications.