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A case of secondary syphilis with HIV, resembling borderline lepromatous leprosy.

Mani MZ, Kanish B, Kwatra K, Chaudhary PR, Bhatia A - Indian J Sex Transm Dis (2015 Jul-Dec)

Bottom Line: We are reporting an unusual case of secondary syphilis, in a homosexual male patient, which resembled borderline lepromatous leprosy, and in whom the diagnosis was considered on clinical grounds.The patient also had concomitant HIV infection, with asymptomatic neurosyphilis.He improved with three standard, weekly injections of benzathine penicillin, along with 2 g of intravenous ceftriaxone daily for 15 days.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Christian Medical College and Hospital, Ludhiana, Punjab, India.

ABSTRACT
We are reporting an unusual case of secondary syphilis, in a homosexual male patient, which resembled borderline lepromatous leprosy, and in whom the diagnosis was considered on clinical grounds. The patient also had concomitant HIV infection, with asymptomatic neurosyphilis. His rapid plasma reagin test was reactive in 1:128 dilution. He improved with three standard, weekly injections of benzathine penicillin, along with 2 g of intravenous ceftriaxone daily for 15 days. This case is being reported to highlight the need for a high index of suspicion in diagnosing unusual cases of secondary syphilis, especially in those with concomitant HIV infection.

No MeSH data available.


Related in: MedlinePlus

A periappendageal and perineural infiltrate (H and E ×200, biopsy 1)
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Figure 3: A periappendageal and perineural infiltrate (H and E ×200, biopsy 1)

Mentions: His skin biopsy performed from two different plaques showed essentially similar features, with the presence of a florid subepidermal granulomatous infiltrate without a free Grenz zone, in biopsy 2. A few Langhans and multinucleate giant cells were also seen, apart from a periappendageal and perineural granulomatous infiltrate rich in plasma cells [Figure 3, biopsy 1] that was breaking up the arrectores pilorum muscle. In addition, endothelial swelling, with luminal narrowing, and a perivascular infiltrate of lymphocytes and plasma cells was also present. The special stain was negative for lepra bacilli. The skin biopsy was consistent with a diagnosis of granulomatous secondary syphilis.


A case of secondary syphilis with HIV, resembling borderline lepromatous leprosy.

Mani MZ, Kanish B, Kwatra K, Chaudhary PR, Bhatia A - Indian J Sex Transm Dis (2015 Jul-Dec)

A periappendageal and perineural infiltrate (H and E ×200, biopsy 1)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660561&req=5

Figure 3: A periappendageal and perineural infiltrate (H and E ×200, biopsy 1)
Mentions: His skin biopsy performed from two different plaques showed essentially similar features, with the presence of a florid subepidermal granulomatous infiltrate without a free Grenz zone, in biopsy 2. A few Langhans and multinucleate giant cells were also seen, apart from a periappendageal and perineural granulomatous infiltrate rich in plasma cells [Figure 3, biopsy 1] that was breaking up the arrectores pilorum muscle. In addition, endothelial swelling, with luminal narrowing, and a perivascular infiltrate of lymphocytes and plasma cells was also present. The special stain was negative for lepra bacilli. The skin biopsy was consistent with a diagnosis of granulomatous secondary syphilis.

Bottom Line: We are reporting an unusual case of secondary syphilis, in a homosexual male patient, which resembled borderline lepromatous leprosy, and in whom the diagnosis was considered on clinical grounds.The patient also had concomitant HIV infection, with asymptomatic neurosyphilis.He improved with three standard, weekly injections of benzathine penicillin, along with 2 g of intravenous ceftriaxone daily for 15 days.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Christian Medical College and Hospital, Ludhiana, Punjab, India.

ABSTRACT
We are reporting an unusual case of secondary syphilis, in a homosexual male patient, which resembled borderline lepromatous leprosy, and in whom the diagnosis was considered on clinical grounds. The patient also had concomitant HIV infection, with asymptomatic neurosyphilis. His rapid plasma reagin test was reactive in 1:128 dilution. He improved with three standard, weekly injections of benzathine penicillin, along with 2 g of intravenous ceftriaxone daily for 15 days. This case is being reported to highlight the need for a high index of suspicion in diagnosing unusual cases of secondary syphilis, especially in those with concomitant HIV infection.

No MeSH data available.


Related in: MedlinePlus