A case of pulmonary nodules in a patient living with HIV diagnosed with secondary syphilis

A Case of Oropharyngeal Syphilis

We present a case of a 50-year-old male who complained of a sore throat persisting for 2 months. Upon physical examination, multiple mucous patches were observed in the oropharynx region, but no skin lesions were found. Fiberoptic laryngoscopy confirmed these findings. The Treponema pallidum particle agglutination test and toluidine red unheated serum test (TRUST) were positive with a titer of TRUST 1:64. The patient admitted to engaging in extramarital sexual activities with several females but no males. Based on the clinical manifestations and laboratory test results, a diagnosis of secondary syphilis of the oropharynx was established. He was treated with 2.4 million units of benzathine penicillin G by intramuscular injection once a week for 3 weeks. After 1 month, the lesions completely disappeared without any symptoms. The titer of TRUST reduced to 1:2 in 1-year follow-up. This report aims to enhance physicians' understanding and recognition of oropharyngeal syphilis, enabling timely diagnosis and effective management.

Cervical Syphilitic Lymphadenitis in a 29-Year-Old Female: A Case Report

Cervical lymphadenopathy is a common condition characterized by the enlargement of lymph nodes. It can have various causes, including infections, inflammatory conditions, and neoplastic processes. Syphilis, a sexually transmitted disease that progresses through multiple stages, can also be a rare cause of cervical lymphadenopathy, particularly in HIV-positive individuals. In this case report, we describe a patient presenting with throat pain, systemic symptoms, and cervical lymphadenopathy, initially clinically suggestive of lymphoma but ultimately determined to be caused by syphilis of unknown duration. This case highlights the importance of considering syphilis in the differential diagnosis of cervical lymphadenitis, particularly in patients with risk factors, such as intravenous drug use and HIV infection, and the need for a thorough evaluation of the patient's social and medical histories to diagnose and treat the condition accurately.

A Case of Secondary Pulmonary Syphilis - The Utility of mNGS in Bronchoalveolar Lavage Fluid: A Case Report

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. Here, we report a rare case of secondary pulmonary syphilis, which was diagnosed by metagenomic next-generation sequencing (mNGS) in bronchoalveolar lavage fluid (BALF). Direct pulmonary involvement by T. pallidum was suggested by a positive mNGS result in BALF. One month after treatment with benzathine penicillin G (2.4 million units, three doses), a repeated CT scan showed the radiological resolution. To our knowledge, this is the first reported case of secondary pulmonary syphilis diagnosed by mNGS in BALF.

Secondary syphilis of the oropharynx and cervical lymph nodes: a case report

Secondary syphilis rarely affects the head and neck including the oropharynx and cervical lymph nodes. These patients present with throat pain, cystic/necrotic lymphadenopathy, and mucosal swelling. Sometimes this constellation of symptoms can be mistaken for head and neck cancer. We report a case of an enlarging throat and painless cystic neck mass in a transgender woman in her forties who was initially suspected to have oropharyngeal squamous cell carcinoma. A subsequent workup revealed the presence of spirochetes without cellular atypia consistent with secondary syphilis. We include the ultrasonography images as well as an endoscopic photograph of the oropharyngeal manifestation in this report.