1/20. Syphilitic hepatitis in hiv-infected patients: a report of 7 cases and review of the literature.BACKGROUND: A recent resurgence of primary and secondary syphilis has been observed in certain population groups, particularly among persons infected with human immunodeficiency virus (hiv). liver involvement is an infrequently recognized complication of early syphilis, with no previous reports among hiv-infected patients. methods: We describe 7 cases of syphilitic hepatitis in hiv-positive individuals and review the literature. RESULTS: At our institutions, all patients presented with a rash consistent with secondary syphilis. Each case was characterized by a conspicuous increase in serum alkaline phosphatase level (mean level /- standard deviation, 905 /- 523.6 IU/L) and milder elevations in serum transaminase levels. The mean CD4 absolute T cell count was 317 cells/mm3, and the median rapid plasma reagin (RPR) titer was 1 : 128. There was a significant correlation between higher CD4 cell counts and the RPR titers (R=0.93; P=.002). Symptomatic resolution and biochemical improvement, particularly a significant decrease in serum alkaline phosphatase levels (P=.02), occurred following antibiotic therapy. CONCLUSIONS: Hepatic dysfunction is not uncommon in hiv-infected persons and is attributable to multiple causes. In the appropriate clinical setting, syphilitic hepatitis is an easily diagnosed and reversible etiology of liver dysfunction. The recognition of this entity will prevent unnecessary evaluation of abnormal liver enzyme levels in hiv-positive patients.- - - - - - - - - - ranking = 1keywords = syphilis (Clic here for more details about this article) |
2/20. Late syphilis in a cardiac transplant patient.patients undergoing cardiac transplantation are routinely screened for prior exposure to treponema pallidum, the bacterium implicated in syphilis. Although acute syphilis typically presents with a painless genital chancre, chronic syphilis can manifest in protean forms and linger undiagnosed. Left untreated, syphilis can cause multi-system disease, particularly irreversible neurologic damage. We describe a case of cutaneous secondary syphilis, neurosyphilis and luetic hepatitis in a cardiac transplant patient.- - - - - - - - - - ranking = 3.3333333333333keywords = syphilis (Clic here for more details about this article) |
3/20. Hepatitis and glomerulonephritis in secondary syphilis.In early secondary syphilis, predominant features of spirochetal infection may include hepatitis and glomerulonephritis. We report a 27-year-old woman with characteristic physical, laboratory, and microscopic findings of syphilitic hepatitis and glomerulonephritis; she responded to penicillin therapy and recovered completely. The importance of clinically and pathologically recognizing this treatable disease is emphasized.- - - - - - - - - - ranking = 1.6666666666667keywords = syphilis (Clic here for more details about this article) |
4/20. Granulomatous hepatitis in secondary syphilis.An unusual case of a well-documented granulomatous hepatitis in secondary syphilis in a 47-year-old male is presented. This hepatic pathology in secondary syphilis is summarised, and a review of the literature regarding syphilitic granulomatous hepatitis presented.- - - - - - - - - - ranking = 2keywords = syphilis (Clic here for more details about this article) |
5/20. Unsuspected syphilitic hepatitis in a patient with low-grade proteinuria and abnormal liver function.A 25-year-old patient was found to have cholestatic liver enzyme abnormalities during assessment for asymptomatic low-grade proteinuria at the US Naval Hospital in Portsmouth, virginia. These abnormalities persisted for a 6-month period, and an extensive workup, including viral serologic studies, rapid plasma reagin test, iron studies, ceruloplasmin, antimitochondrial, antinuclear, and anti-human immunodeficiency virus antibodies, endoscopic retrograde cholangiopancreatography, and liver biopsy, was unrevealing until serologic tests for syphilis were repeated to evaluate a new onset of urethral discharge. The patient had none of the more characteristic signs of secondary syphilis. The liver enzyme abnormalities rapidly resolved after treatment with penicillin. Syphilis remains the great impostor and still must be considered in the differential diagnosis of unexplained liver enzyme abnormalities, even in a patient with no symptoms or signs of early syphilis.- - - - - - - - - - ranking = 1keywords = syphilis (Clic here for more details about this article) |
6/20. Testicular cancer in homosexual men with cellular immune deficiency: report of 2 cases.Embryonal cell carcinoma of the testis was seen in 2 homosexuals with peripheral lymphadenopathy of the head and neck, and abnormal cellular immunity measured by reduced T helper cells and increased T suppressor cells. One patient had no history of venereal disease but had taken marijuana, nitrites and methyl-dextroamphetamines regularly. The other patient had a history of syphilis, gonorrhea, hepatitis and venereal warts but rarely used inhalant recreational drugs. Both patients had smoked cigarettes. Neither patient had any known risk factors that predisposed to testicular cancer. biopsy of a supraclavicular lymph node in 1 patient showed histological features of reactive follicular hyperplasia similar to those described previously in the acquired immune deficiency syndrome. These cases of testicular cancer increase the spectrum of rare cancers developing in young male homosexuals with acquired cellular immune abnormalities.- - - - - - - - - - ranking = 0.33333333333333keywords = syphilis (Clic here for more details about this article) |
7/20. Cardiolipin-fluorescent (M1) antimitochondrial antibody and cholestatic hepatitis in secondary syphilis.A 27-year-old black male with secondary syphilis and cholestatic jaundice is presented. The liver biopsy was believed to be most consistent with large bile duct obstruction, but both the ultrasound and endoscopic retrograde cholangiography were normal. Prior to treatment with penicillin, his serum was positive for antimitochondrial antibody. After treatment, the antibody was no longer detectable and the jaundice gradually resolved. The patient's pretreatment serum was, after further analysis, found to be positive for the antibody to the M1 antimitochondrial antigen subtype, which is identical to cardiolipin, the antigen in both the VDRL and Wasserman tests. A review of hepatic involvement in secondary syphilis is presented.- - - - - - - - - - ranking = 2keywords = syphilis (Clic here for more details about this article) |
8/20. nephrotic syndrome and hepatitis in early syphilis.A 54 year old man presented with features of acute hepatitis and the nephrotic syndrome. A diagnosis of active syphilis was only made by chance after extensive investigation. Syphilis should be considered in the differential diagnosis of both acute hepatitis and the nephrotic syndrome occurring separately as well as together.- - - - - - - - - - ranking = 1.6666666666667keywords = syphilis (Clic here for more details about this article) |
9/20. Syphilitic hepatitis: a case report and review of the literature.Although recognized for more than 400 yr hepatic complications of syphilis are uncommon and frequently overlooked as explanations for acute liver dysfunction. We describe a case of acute hepatitis during the course of relapsing secondary syphilis, with additional confirmation of the diagnosis by lymph node biopsy demonstrating treponema pallidum.- - - - - - - - - - ranking = 0.66666666666667keywords = syphilis (Clic here for more details about this article) |
10/20. liver disease in early syphilis.Atypical manifestations of early syphilis, although uncommon, may represent diagnostic difficulties and delay therapy. We describe two cases of hepatitis complicating early syphilis. Clues to the diagnosis of early syphilitic hepatitis include the presence of perianal lesions and disproportionate increases in the serum alkaline phosphatase level. biopsy results were nonspecific. The major differential diagnostic consideration is hepatitis b with false-positive serologic findings. The abnormalities of liver function respond to standard therapy for secondary syphilis. Follow-up of patients and their contacts is essential.- - - - - - - - - - ranking = 2.3333333333333keywords = syphilis (Clic here for more details about this article) |
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