1/10. Unusual location of syphilitic alopecia: a case report.A case of syphilitic alopecia on the legs of young man is described. Both positive serologic tests and the clinical response to treatment with penicillin suggest that this alopecia was due to syphilis. This report suggests that the physician should be aware of the possible unusual location of syphilitic alopecia at sites other than the scalp, eyebrows, and beard.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/10. Secondary syphilis-related oral ulcers: report of four cases.Establishing a diagnosis of syphilis, whatever the stage of the disease, can be difficult because syphilis is a great mimic in clinical morphology and histology. Many patients infected with venereal diseases have oral manifestations, but very few dentists and physicians have the proper experience to diagnose syphilis or other STDs from oral lesions. Oral secondary syphilis appears to be very uncommon, and few cases have been reported over the recent past. We present 4 patients who developed secondary syphilis-related oral lesions of moist ulcers, irregular linear erosions termed 'snail-track' ulcers, or erythematous mucous patches on the labial mucosa, buccal mucosa, palate, or tongue. Concurrent human immunodeficiency virus (hiv) infection was diagnosed in 1 patient. The histological examination in 2 patients showed dense subepithelial inflammatory cell infiltration comprised predominantly of plasma cells, and it was of practical help in the diagnosis of syphilis. The diagnostic value of a histological examination, serologic tests, and treatment of syphilis are discussed. Obviously, coinfection with hiv will complicate the clinical presentation, diagnosis, and management of syphilis. Concurrent hiv infection should be considered in any patient with a sexually transmitted disease including syphilis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/10. syphilis. A new look at an old killer.Thirty-four-year-old George Talbot was admitted to your medical/surgical unit with deep vein thrombosis of his left leg, probably related to intravenous drug abuse. So it's no surprise that Mr. Talbot is receiving heparin IV. Today, however, you notice that his physician has prescribed one dose (2.4 million units) of benzathine penicillin IM. You're not sure why until you check the patient's lab work. Mr. Talbot's rapid plasma reagin (RPR) test was reactive. The physician is treating Mr. Talbot for syphilis.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/10. Spinal syphilis: the problem of fluorescent treponemal antibody in the cerebrospinal fluid.Spinal manifestations of syphilis are now uncommon. Three adults with presumptive nontabetic spinal syphilis are presented. This paper should serve as a reminder to physicians that cases of late syphilis continue to occur and may be manifested as obscure spinal syndromes and be misdiagnosed unless the possibility of syphilis is constantly kept in mind. Some of the clinical dilemmas associated with the reactivity of fluorescent treponemal antibody in the cerebrospinal fluid are discussed,- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/10. Painful red leg nodules and syphilis: a consideration in patients with erythema nodosum-like illness.An adolescent girl presented with the classical physical findings of painful red nodules on the legs; the lesions were suggestive of erythema nodosum. The usual underlying causes were explored and found to be absent. Because she was sexually active, the patient was also routinely screened for sexually transmitted diseases. A rapid plasma reagin test was performed and found to be strongly positive. The confirmatory fluorescent treponemal antibody test was also positive. A diagnosis of syphilis was made, and she was treated with benzathine penicillin g (2.4 X 10(6) units). This report is a reminder that when a patient is suspected of having erythema nodosum, the physician should check for syphilis as well as for tuberculosis, sarcoidosis, reaction to a drug, and streptococcal disease. panniculitis can be an important clinical sign of secondary syphilis that should never be overlooked.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/10. Infectious syphilis mimicking neoplastic disease.Five patients who were initially evaluated for malignant neoplasm actually had infectious syphillis (one primary, two secondaries, two secondaries with persistence of primary). Two patients were considered for radical surgery and one for extensive radiation and/or chemotherapy. In four patients an elevated routine admission VDRL was the first indication of the correct diagnosis. Dark-field examination is the most important laboratory test in the diagnosis of primary syphillis; VDRL and FTA-ABS are most important in confirming secondary syphillis. Penicillin remains the drug of choice for therapy. At a time when the incidence of sexually transmitted diseases is increasing, it is extremely important to develop adequate educational programs for medical students and physicians.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/10. Rectal syphilis mimicking histiocytic lymphoma.homosexuality is being recognized with increasing frequency in the united states, and the physician must be knowledgeable of the presentations of venereal infection in this population. A 23-year-old man who denied homosexuality presented with a rectal mass and diffuse adenopathy. biopsy of the mass was interpreted as histiocytic lymphoma. Subsequent serology had positive results for syphilis. Further questioning revealed a history of anorectal intercourse, and special stains of the mass revealed spirochetes. syphilis must be considered in any young patient presenting with a rectal mass, regardless of the biopsy histologic characteristics or sexual history.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/10. Pigmented penile lesions (fixed drug eruptions) associated with tetracycline therapy for sexually transmitted diseases.Two men had pigmented penile lesions that were diagnosed as fixed drug eruptions. The lesions developed after ingestion of tetracycline for nongonococcal urethritis and syphilis, respectively. Because use of tetracycline for treatment of sexually transmitted diseases is becoming more common, physicians must be able to recognize the allergic reactions to this drug.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/10. Gastric syphilis.A sexually transmitted disease is seldom considered in the differential diagnosis of patients with clinical gastritis. A patient with gastric syphilis is reported to alert emergency department physicians to this entity. history and physical findings of syphilis should be sought and rapid plasma reagin tests should be obtained in the patient with severe or refractory gastritis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/10. Preschoolers with syphilis.syphilis in preschoolers is rarely described in current medical literature, despite the rise in syphilis in both the adult and the pediatric populations during the past decade. Since that time, 3 children between 3 and 4 years of age have been diagnosed with syphilis at the Children's Hospital of philadelphia. The presentations and clinical manifestations of syphilis in these 3 children are described, and the difficulty in identifying the source of infection is discussed. The presentations of these children included nephrosis and secondary syphilis, the corymbiform and palmar rash of syphilis, and subtle signs of late congenital infection in an otherwise asymptomatic child. One child had documented congenital infection, 1 had probable congenital infection that went untreated, and 1 did not have appropriate neonatal testing documented. None of the children gave a verbal history of sexual abuse, although it is likely that all three cases resulted from sexual abuse. The evaluation of preschool children with syphilis is confounded by the interpretation of acquired infection in consideration of a history of possible or documented congenital disease. The assessment is complicated further by problems with recognition of clinical disease, the inability of young children to provide a history, prenatal and neonatal testing methods used, changes in treatment recommendations made during the past decade, and inadequate follow-up to document cure of congenitally infected infants. With the increase in syphilis seen in recent years, physicians are more likely to encounter preschoolers with syphilis. Our ability to document acquired infection, however, is hampered by the difficulties encountered in following recommended guidelines for evaluation and follow-up and by limitations in interviewing young victims of sexual abuse, which may impair our ability to protect children from additional harm. Understanding the pathophysiology and progression of this disease remains challenging even in this modern era.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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