Syphilitic periostitis is not a common manifestation of bone involvement in congenital and acquired late syphilis, and it’s rarely seen in secondary syphilis. Syphilis should be considered as a differential diagnosis...Syphilitic periostitis is not a common manifestation of bone involvement in congenital and acquired late syphilis, and it’s rarely seen in secondary syphilis. Syphilis should be considered as a differential diagnosis in patient with deep bony pain that worsens at night. We report a case of secondary syphilis presented with multiple bony swelling of both tibiae (sabre-like) and other long bones.展开更多
Objective: For the purpose of understanding the changingprocess of syphilis histomorphology and its injury mechanism,the ultrastructure of dermatic tissues of secondary syphiliswas studied. Methods: Different skin inj...Objective: For the purpose of understanding the changingprocess of syphilis histomorphology and its injury mechanism,the ultrastructure of dermatic tissues of secondary syphiliswas studied. Methods: Different skin injury tissues of secondary syphilispatients, whose serum RPR and TPHA tests in the lab bothappeared positive reaction, were observed throughtransmission electron microscope(TEM). Results: Inflammations appeared on epidermides and coria,a great deal of neutrocytes, lymphocytes and a small amountof plasma innltrated them. Karyopyknosis, karyorrhexis,epicyte lysis and mitochondrion vacular degenerationoccurred. Spirocheta pallida was distributed on intercellularsubstances, epicytes and collagenous fibers. The epicytes werepressed to foveation. Conclusion The pathological change ofcharacteristic tissue ultrastructure reported here is ahistomorphological foundation to study the organism injurymechanism caused by syphilis.展开更多
Introduction: Syphilis consists in a systemic infect contagious pathology with a chronic character. The etiological agent consists of an anaerobic spirochete bacterium, Treponema pallidum. Laboratory diagnosis can be ...Introduction: Syphilis consists in a systemic infect contagious pathology with a chronic character. The etiological agent consists of an anaerobic spirochete bacterium, Treponema pallidum. Laboratory diagnosis can be made through a direct investigation of the etiologic agent or non-treponemal (VDRL) and treponemal (FTA-Abs) serological tests. False-negative results are rare. Objectives: The present report presents a rare case of a man with a secondary syphilis syndrome who was initially undiagnosed due to the prozone effect, since he presented VDRL in low titers, and was later confirmed with a new diluted serum sample and VDRL and FTA-Abs, which were positive. Conclusion: A close look should be given to patients who, although the clinical condition is compatible, complementary exams may not be, and clinical cases should be carefully evaluated so that the patient is not treated late.展开更多
BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignan...BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignant syphilis accompanied with neurosyphilis.CASE SUMMARY A 56-year-old man present with a 2-mo history of spreading ulcerous and necrotic papules and nodules covered with thick crusts over the face,trunk,extremities,and genitalia.The patient was diagnosed with malignant syphilis accompanied by neurosyphilis based on the characteristic morphology of the lesions,positive serological and cerebrospinal fluid tests for syphilis,brain magnetic resonance imaging,and histopathology,along with resolution of the lesions following the institution of penicillin therapy.The lesions and neurological condition successfully resolved after a course of treatment with penicillin.CONCLUSION We suggest that neurosyphilis should be considered whenever people have psychiatric symptoms without cutaneous lesions or human immunodeficiency virus.展开更多
Introduction:The manifestations of syphilis are varied,and serology can establish the diagnosis early,especially in rare cases.We report a case of chancre redux(a rare recurrence of primary syphilis),which was embedde...Introduction:The manifestations of syphilis are varied,and serology can establish the diagnosis early,especially in rare cases.We report a case of chancre redux(a rare recurrence of primary syphilis),which was embedded within a secondary syphilitic penile skin plaque.There were missed opportunities at earlier diagnosis as serology for syphilis was not ordered.Case presentation:A 56-year-old man presented with thickened penile plaques for five months.He reported a small penile ulcer approximately one month prior.There was no history of other skin lesions or rash.However,clinically there was an asymptomatic,indurated ulcer embedded within a plaque which was swab-positive for syphilis by PCR.A punch biopsy of a plaque was spirochaete-positive using an immunoperoxidase stain.The patient’s lesions resolved three weeks after treatment with intramuscular benzathine penicillin.Discussion:Uncommonly reported even in the preantibiotic era,chancre redux is now rare.The ulcer usually recurs at or near the site of the original chancre,and has similar morphological features.The skin lesions of secondary syphilis can exhibit remarkable morphological variety.The most common skin manifestation,a generalized macular rash,was not present at any time in this case.Rather,there were only a couple of nonspecific penile plaques.If biopsy is performed,histologic findings are variable,though typically the inflammatory infiltrate includes plasma cells.A special immunoperoxidase stain can highlight spirochaetes in biopsy sections.Conclusion:This case highlights the importance of considering syphilis in the differential diagnosis of persistent,atypical penile lesions and underscores the need for appropriate serological testing in such instances.展开更多
文摘Syphilitic periostitis is not a common manifestation of bone involvement in congenital and acquired late syphilis, and it’s rarely seen in secondary syphilis. Syphilis should be considered as a differential diagnosis in patient with deep bony pain that worsens at night. We report a case of secondary syphilis presented with multiple bony swelling of both tibiae (sabre-like) and other long bones.
文摘Objective: For the purpose of understanding the changingprocess of syphilis histomorphology and its injury mechanism,the ultrastructure of dermatic tissues of secondary syphiliswas studied. Methods: Different skin injury tissues of secondary syphilispatients, whose serum RPR and TPHA tests in the lab bothappeared positive reaction, were observed throughtransmission electron microscope(TEM). Results: Inflammations appeared on epidermides and coria,a great deal of neutrocytes, lymphocytes and a small amountof plasma innltrated them. Karyopyknosis, karyorrhexis,epicyte lysis and mitochondrion vacular degenerationoccurred. Spirocheta pallida was distributed on intercellularsubstances, epicytes and collagenous fibers. The epicytes werepressed to foveation. Conclusion The pathological change ofcharacteristic tissue ultrastructure reported here is ahistomorphological foundation to study the organism injurymechanism caused by syphilis.
文摘Introduction: Syphilis consists in a systemic infect contagious pathology with a chronic character. The etiological agent consists of an anaerobic spirochete bacterium, Treponema pallidum. Laboratory diagnosis can be made through a direct investigation of the etiologic agent or non-treponemal (VDRL) and treponemal (FTA-Abs) serological tests. False-negative results are rare. Objectives: The present report presents a rare case of a man with a secondary syphilis syndrome who was initially undiagnosed due to the prozone effect, since he presented VDRL in low titers, and was later confirmed with a new diluted serum sample and VDRL and FTA-Abs, which were positive. Conclusion: A close look should be given to patients who, although the clinical condition is compatible, complementary exams may not be, and clinical cases should be carefully evaluated so that the patient is not treated late.
基金Supported by the National Natural Science Foundation of China,No.81773337the Shandong Traditional Chinese Medicine Science and Technology Development Plans,China,No.2017-415+1 种基金the Medical and Health Science Technology Project of Shandong Province,China,No.2017WS345the Natural Science Foundation of Shandong Province,China,No.ZR2015HL127
文摘BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignant syphilis accompanied with neurosyphilis.CASE SUMMARY A 56-year-old man present with a 2-mo history of spreading ulcerous and necrotic papules and nodules covered with thick crusts over the face,trunk,extremities,and genitalia.The patient was diagnosed with malignant syphilis accompanied by neurosyphilis based on the characteristic morphology of the lesions,positive serological and cerebrospinal fluid tests for syphilis,brain magnetic resonance imaging,and histopathology,along with resolution of the lesions following the institution of penicillin therapy.The lesions and neurological condition successfully resolved after a course of treatment with penicillin.CONCLUSION We suggest that neurosyphilis should be considered whenever people have psychiatric symptoms without cutaneous lesions or human immunodeficiency virus.
文摘Introduction:The manifestations of syphilis are varied,and serology can establish the diagnosis early,especially in rare cases.We report a case of chancre redux(a rare recurrence of primary syphilis),which was embedded within a secondary syphilitic penile skin plaque.There were missed opportunities at earlier diagnosis as serology for syphilis was not ordered.Case presentation:A 56-year-old man presented with thickened penile plaques for five months.He reported a small penile ulcer approximately one month prior.There was no history of other skin lesions or rash.However,clinically there was an asymptomatic,indurated ulcer embedded within a plaque which was swab-positive for syphilis by PCR.A punch biopsy of a plaque was spirochaete-positive using an immunoperoxidase stain.The patient’s lesions resolved three weeks after treatment with intramuscular benzathine penicillin.Discussion:Uncommonly reported even in the preantibiotic era,chancre redux is now rare.The ulcer usually recurs at or near the site of the original chancre,and has similar morphological features.The skin lesions of secondary syphilis can exhibit remarkable morphological variety.The most common skin manifestation,a generalized macular rash,was not present at any time in this case.Rather,there were only a couple of nonspecific penile plaques.If biopsy is performed,histologic findings are variable,though typically the inflammatory infiltrate includes plasma cells.A special immunoperoxidase stain can highlight spirochaetes in biopsy sections.Conclusion:This case highlights the importance of considering syphilis in the differential diagnosis of persistent,atypical penile lesions and underscores the need for appropriate serological testing in such instances.
