- 2022, Volume 80 - Number 3
- Published: October 24, 2022
Syphilitic hepatitis: a rare complication of secondary syphilis. A case report
Margarida Caldeira 1, Ana L. João 2, Mafalda Pestana 3, I. Canha 4, G. Simões 4, C. Fernandes 5
1 Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; 2 Department of Dermatology and Venereology, Hospital de Santo António dos Capuchos, Unidade Local de Saúde São José; Centro Clínico Académico de Lisboa. Lisboa, Portugal; 3 Department of Dermatology and Venereology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal; 4 Gastroenterology Department - Hospital de Santo António dos Capuchos - Centro Hospitalar Universitário de Lisboa Central, E.P.E. - Alameda Santo António dos Capuchos, Lisboa; 5 Dermatology and Venereology Department; E.P.E.- Alameda Santo António dos Capuchos, Lisboa
Margarida Caldeira, Ana L. João, Mafalda Pestana, I. Canha, G. Simões, C. Fernandes
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Ana L. João, Email not available
Abstract
Syphilis is a sexually transmitted disease caused by Treponema pallidum, progressing through active and latent stages if left untreated. Hepatic involvement can occur in secondary syphilis, but this is an uncommon complication, with few published case reports. A 34-year-old man without significant medical history was admitted to the gastroenterology department with a 2-week history of unexplained jaundice and acute cholestatic hepatitis. He also presented with erythematous papules and plaques in the genital area, suggestive of secondary syphilis. T. pallidum hemaglutination assay and venereal disease research laboratory test were both positive, the latter with a 1:16 titer. The diagnosis of secondary syphilis with hepatic involvement was considered. The improvement of cutaneous and laboratory findings after intramuscular benzathine penicillin injection supported this hypothesis. Symptomatic cholestatic hepatitis is a rare feature of the systemic spectrum of secondary syphilis. The clinical and laboratorial response after penicillin treatment is a strong clue for this diagnosis.
