Thyroid gland involvement in secondary syphilis: a case report.

BACKGROUND: Syphilis is a systemic, infectious disease caused by Treponema pallidum and is notorious for the variety of its clinical presentations. OBJECTIVE: We report a case of secondary syphilis with thyroid gland and ocular involvement in a human immunodeficiency virus (HIV) negative patient. METHODS: We present the patient's history, clinical findings, laboratory test results, imaging and management. RESULTS: A 39-year-old Caucasian, HIV unaffected woman presented with acute midline neck swelling, dyspnea and difficulty to talk or swallow. Serologic tests for syphilis were positive. PCR performed on a thyroid fine needle aspiration cytology (FNAC) aspirate was positive for Treponema pallidum. Skin lesions and unilateral loss of vision were present. Treatment with intravenous benzyl-penicillin showed a good regression of symptoms. CONCLUSION: We report an unusual case of thyroid swelling in a secondary syphilis infection. Awareness of syphilis as a differential diagnosis is important in a risk population.

Two-Stage Urethroplasty with Buccal Mucosa for Penoscrotal Hypospadias Reconstruction in a Male with a 46,XX Karyotype.

We present a case regarding a 32-year old African male with penoscrotal hypospadias, left cryptorchidism and a left inguinal hernia. There were moderate masculinization characteristics. He underwent a Lichtenstein hernia repair with perioperative biopsies of the left inguinal testis and epididymis. Microscopic examination showed a Sertoli-only left testis with Leydig-cell hyperplasia and the left epididymis consisted of ovarian tissue with corpora albicantia and maturing follicles. Endocrinological evaluation showed a sex-determining region Y (SRY) negative 46,XX karyotype. We successfully performed a two-stage urethroplasty with buccal mucosa graft to reconstruct his penoscrotal hypospadias.

Bilateral spontaneous pneumothorax in a patient with pulmonary rheumatoid nodules, secondary infected by Aspergillus.

This case report describes a 50-year-old woman with rheumatoid arthritis (RA) in whom nodular opacities were found on chest X-ray. She developed a bilateral spontaneous pneumothorax treated with surgical pleurodesis. Cultures remained negative. Histological examination of specimens confirmed the clinical diagnosis of rheumatoid granulomata. Therefore, corticosteroid therapy was started, after which the nodules decreased slightly in size and inflammatory parameters normalized. Three months later, she presented with respiratory insufficiency based on pulmonary fungus infection. Differential diagnosis between rheumatoid nodules and granulomas caused by Aspergillus is difficult in RA patients with pulmonary nodular lesions; in this case, both complications appeared subsequently.