Malignant syphilis with ocular involvement in an HIV–infected patient
| Autor: | V Ansidei, Maria Bruna Pasticci, Stefano Simonetti, Carlo Tomasini, Franco Baldelli, G. V. De Socio |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Sexually transmitted disease Pathology medicine.medical_specialty Eye Diseases lues Biopsy The great imitator HIV Infections Minocycline Penicillins Dermatology Tigecycline medicine Humans Pharmacology (medical) Syphilis Treponema pallidum medicine.diagnostic_test business.industry Public Health Environmental and Occupational Health HIV medicine.disease Immunohistochemistry malignant syphilis Anti-Bacterial Agents Treatment Outcome Infectious Diseases Leonine facies Skin biopsy Differential diagnosis business Rare disease |
| Zdroj: | International Journal of STD & AIDS. 22:298-300 |
| ISSN: | 1758-1052 0956-4624 |
| Popis: | Malignant syphilis is now considered a rare disease, more commonly affecting individuals with poor health, malnutrition or HIV infection. We present a 34-year-old man with HIV infection who developed multiple atypical cutaneous ulcerations, leonine facies, a scleral nodule and keratitis with visual loss. The diagnosis of malignant syphilis was delayed due to the insidious presentation, but was confirmed via immunohistochemical (IHC) staining with anti-Treponema antibodies of a skin biopsy. Significant clinical improvement was observed following a 15-day course of penicillin and tigecycline therapy. In advanced HIV disease, cutaneous manifestations are often difficult to identify and present a challenge for the clinician. Clinical manifestations of secondary syphilis vary greatly, earning the epigram of ‘the great imitator’. It is important to recognize atypical presentations of syphilis, especially among HIV-infected individuals. Unlike historical cases of malignant syphilis, Treponema pallidum was found in the tissue section using IHC staining methods. We emphasize the importance of lues maligna in the differential diagnosis of HIV-infected patients with diffuse ulceronodular lesions as well as the usefulness of histological investigations and IHC studies. |
| Databáze: | OpenAIRE |
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