Subject(s)
Scrotum/pathology , Syphilis/diagnosis , Adult , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Humans , Male , Penicillin G Benzathine/pharmacology , Penicillin G Benzathine/therapeutic use , Scrotum/drug effects , Syphilis/drug therapySubject(s)
HIV Infections/complications , Syphilis/diagnosis , Antiretroviral Therapy, Highly Active , Biopsy , Diagnosis, Differential , HIV Infections/drug therapy , Humans , Injections, Intramuscular , Leprosy, Tuberculoid , Male , Middle Aged , Penicillin G Benzathine/administration & dosage , Penicillin G Benzathine/therapeutic use , Syphilis/drug therapy , Treatment OutcomeSubject(s)
HIV Infections/diagnosis , Skin Ulcer/diagnosis , Syphilis/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , HIV Infections/complications , HIV Infections/drug therapy , Humans , Male , Penicillin G Benzathine/therapeutic use , Skin Ulcer/complications , Skin Ulcer/drug therapy , Syphilis/complications , Syphilis/drug therapyABSTRACT
The association between syphilis, leprosy, and human immunodeficiency virus (HIV) is not well documented, and the emergence of isolated cases raises the interest and indicates that this triple coinfection can occur. We report the case of a 42-year-old man from Rio de Janeiro, Brazil, who presented with erythematous papules on the trunk, back, and upper and lower extremities; an erythematous plaque on the upper abdomen; and an erythematous violaceous plaque on the right thigh with altered sensitivity. Laboratory investigation showed a reagent VDRL test (1:512) and positive test results for Treponema pallidum hemagglutination. Treatment with benzathine penicillin (2,400,000 U intramuscularly) was started (2 doses 1 week apart). On follow-up 40 days later, the lesions showed partial improvement with persistence of the plaques on the right thigh and upper abdomen as well as a new similar plaque on the back. Further laboratory examinations showed negative bacilloscopy, positive HIV test, and histologic findings consistent with tuberculoid leprosy. The patient was started on multidrug therapy for paucibacillary leprosy with clinical improvement; the patient also was monitored by the HIV/AIDS department. We emphasize the importance of clinical suspicion for a coinfection case despite the polymorphism of these diseases as well as the precise interpretation of laboratory and histopathology examinations to correctly manage atypical cases.
Subject(s)
HIV Infections/diagnosis , Leprosy, Paucibacillary/diagnosis , Syphilis/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , Brazil , Coinfection , Follow-Up Studies , HIV Infections/physiopathology , Humans , Leprosy, Paucibacillary/drug therapy , Leprosy, Paucibacillary/pathology , Male , Penicillin G Benzathine/therapeutic use , Syphilis/drug therapy , Syphilis/pathology , Treatment Outcome , Treponema pallidum/isolation & purificationABSTRACT
There are diverse skin manifestations of both leprosy and syphilis. These diseases can appear similar to many other dermatologic conditions as well as to systemic diseases with dermatologic signs. Nodular syphilis is an uncommon type of secondary syphilis. We present here a person from a leprosy-endemic area with diffuse nodular skin lesions of secondary syphilis who was initially suspected of having lepromatous leprosy.
Subject(s)
Skin/pathology , Syphilis/diagnosis , Syphilis/pathology , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Humans , Leprosy, Lepromatous/pathology , Male , Middle Aged , Penicillin G Benzathine/therapeutic use , Syphilis/drug therapyABSTRACT
Nodular secondary syphilis in a 23-year-old Indian man was characterized by numerous papular, nodular and plaque skin lesions, without involvement of the mucous membranes. The histopathology showed sarcoid-like granulomata with lymphocytes, histiocytes, eosinophils, plasma cells and multinucleated giant cells. The differential diagnosis included deep mycoses, leprosy, tuberculosis, sarcoidosis and lymphoma. The results of serological tests and the rapid response to penicillin indicated a correct diagnosis.
Subject(s)
Syphilis, Cutaneous/pathology , Adult , Diagnosis, Differential , Humans , Male , Penicillin G Benzathine/therapeutic use , Penicillins/therapeutic use , Syphilis, Cutaneous/drug therapyABSTRACT
In a borderline lepromatous patient a positive serology for syphilis and HIV 1 has been detected. The patient also had an urinary tract infection with Acinetobacter calcoaceticus. In Paraguay up till now no leprosy cases infected with HIV have been reported.