The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A case of secondary syphilis presenting as multiple pulmonary nodules

  • Kim, Se Joong (Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Lee, Ju-Han (Department of Pathology, Korea University Ansan Hospital) ;
  • Lee, Eung-Seok (Department of Pathology, Korea University Ansan Hospital) ;
  • Kim, Il-Hwan (Department of Dermatology, Korea University Ansan Hospital) ;
  • Park, Hyung Joo (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Shin, Chol (Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Kim, Je Hyeong (Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital)
  • Published : 2013.03.01
⟨ Previous Next ⟩

Abstract

Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement.

Keywords

References

  1. Lee V, Kinghorn G. Syphilis: an update. Clin Med 2008;8:330-333. https://doi.org/10.7861/clinmedicine.8-3-330
  2. Tucker JD, Chen XS, Peeling RW. Syphilis and social upheaval in China. N Engl J Med 2010;362:1658-1661. https://doi.org/10.1056/NEJMp0911149
  3. Goh BT. Syphi l is in adults. Sex Transm Infect 2005;81:448-452. https://doi.org/10.1136/sti.2005.015875
  4. David G, Perpoint T, Boibieux A, et al. Secondary pulmonary syphilis: report of a likely case and literature review. Clin Infect Dis 2006;42:e11-e15. https://doi.org/10.1086/499104
  5. Wohrl S, Geusau A. Clinical update: syphilis in adults. Lancet 2007;369:1912-1914. https://doi.org/10.1016/S0140-6736(07)60895-2
  6. Biro L, Hill AC, Kuf lik EG. Secondary syphilis with unusual clinical and laboratory f indings. JAMA 1968;206:889-891. https://doi.org/10.1001/jama.1968.03150040101027
  7. Coleman DL, McPhee SJ, Ross TF, Naughton JL. Secondary syphilis with pulmonary involvement. West J Med 1983;138:875-878.
  8. Zaharopoulos P, Wong J. Cytologic diagnosis of syphilitic pleuritis: a case report. Diagn Cytopathol 1997;16:35-38. https://doi.org/10.1002/(SICI)1097-0339(199701)16:1<35::AID-DC8>3.0.CO;2-U
  9. Cholankeril JV, Greenberg AL, Matari HM, Reisner MR, Obuchowski A. Solitary pulmonary nodule in secondary syphilis. Clin Imaging 1992;16:125-128. https://doi.org/10.1016/0899-7071(92)90126-T
  10. Sokolovskiy E, Frigo N, Rotanov S, et al. Guidelines for the laboratory diagnosis of syphilis in East European countries. J Eur Acad Dermatol Venereol 2009;23:623-632. https://doi.org/10.1111/j.1468-3083.2008.03021.x

Cited by

  1. Syphilis Presenting as Inflammatory Tumors of the Liver in HIV-positive Homosexual Men vol.38, pp.12, 2013, https://doi.org/10.1097/pas.0000000000000264
  2. Recombinant Treponema pallidum Protein Tp0965 Activates Endothelial Cells and Increases the Permeability of Endothelial Cell Monolayer vol.9, pp.12, 2013, https://doi.org/10.1371/journal.pone.0115134
  3. A Case of Secondary Syphilis Involving Tonsil, Pulmonary, and Multiple Lymph Nodes: 18F-FDG PET/CT Findings vol.40, pp.4, 2015, https://doi.org/10.1097/rlu.0000000000000662
  4. Unusual Presentation of Secondary Syphilis in Korea: 2010-2014 Review vol.10, pp.1, 2015, https://doi.org/10.14777/kjutii.2015.10.1.19
  5. A skin rash with multiple pulmonary nodules vol.24, pp.138, 2013, https://doi.org/10.1183/16000617.00001815
  6. Secondary syphilis with pulmonary involvement vol.30, pp.12, 2013, https://doi.org/10.1111/jdv.13483
  7. Secondary Syphilis with Pulmonary Involvement vol.57, pp.1, 2013, https://doi.org/10.2169/internalmedicine.8439-16
  8. Pulmonary involvement of secondary syphilis vol.29, pp.1, 2013, https://doi.org/10.1177/0956462417717653
  9. Pulmonary nodules with a rash vol.79, pp.4, 2013, https://doi.org/10.12968/hmed.2018.79.4.230
  10. Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma vol.19, pp.None, 2013, https://doi.org/10.12659/ajcr.907127
  11. A case of secondary syphilis with pulmonary involvement and review of the literature vol.29, pp.10, 2013, https://doi.org/10.1177/0956462418765834
  12. Rectal bleeding caused by a syphilitic inflammatory mass vol.12, pp.1, 2013, https://doi.org/10.1136/bcr-2018-226595
  13. Secondary syphilis with pulmonary involvement mimicking lymphoma: a case report vol.52, pp.None, 2013, https://doi.org/10.1590/0037-8682-0044-2019
  14. Cholangitis and pulmonary nodules in a clinical presentation of syphilis in an HIV-infected patient vol.30, pp.8, 2013, https://doi.org/10.1177/0956462418823386
  15. Syphilitic Pulmonary Inflammatory Pseudotumor: A Diagnostic Challenge vol.29, pp.1, 2013, https://doi.org/10.1177/1066896920928584
  16. A case of pulmonary nodules in a patient living with HIV diagnosed with secondary syphilis vol.14, pp.8, 2013, https://doi.org/10.1136/bcr-2021-243765