Painful rash with hoarseness: an atypical presentation of syphilis

BMJ Case Rep. 2018 Dec 27;11(1):e226892. doi: 10.1136/bcr-2018-226892.

Abstract

Syphilis is a sexually transmitted disease that can affect multiple organ systems, with central nervous system involvement at any stage. We present a 53-year-old woman with an unusual truncal rash with painful anogenital lesions, accompanied by patchy alopecia, oral lesions, photophobia and hoarseness. She was found to have positive serological tests for syphilis with cerebrospinal fluid findings suggestive of neurosyphilis. She underwent a 14-day course of intravenous penicillin G and exhibited successful resolution of painful anogenital lesions as well as marked improvement in dermatological, oropharyngeal, laryngeal, and neurological symptoms.

Keywords: dermatology; ear, nose and throat/otolaryngology; infectious diseases; syphilis.

Publication types

  • Case Reports

MeSH terms

  • Alopecia / complications
  • Alopecia / diagnosis
  • Alopecia / drug therapy
  • Alopecia / pathology
  • Anti-Bacterial Agents / therapeutic use
  • Anus Diseases / complications
  • Anus Diseases / diagnosis
  • Anus Diseases / drug therapy
  • Anus Diseases / pathology
  • Female
  • Headache / etiology
  • Hoarseness / diagnosis*
  • Hoarseness / drug therapy
  • Hoarseness / etiology
  • Humans
  • Laryngeal Diseases / complications
  • Laryngeal Diseases / diagnosis
  • Laryngeal Diseases / drug therapy
  • Middle Aged
  • Mouth Diseases / complications
  • Mouth Diseases / diagnosis
  • Mouth Diseases / drug therapy
  • Mouth Diseases / pathology
  • Neurosyphilis / cerebrospinal fluid
  • Neurosyphilis / complications
  • Neurosyphilis / diagnosis*
  • Neurosyphilis / drug therapy
  • Palate, Hard
  • Penicillin G / therapeutic use
  • Photophobia / etiology
  • Syphilis, Cutaneous / diagnosis*
  • Syphilis, Cutaneous / drug therapy
  • Syphilis, Cutaneous / pathology
  • Vulvar Diseases / complications
  • Vulvar Diseases / diagnosis
  • Vulvar Diseases / drug therapy
  • Vulvar Diseases / pathology

Substances

  • Anti-Bacterial Agents
  • Penicillin G