Abstract
Background Human immunodeficiency virus (HIV) and Treponema pallidum coinfection is relatively common and accounts for about 25% of primary and secondary syphilis. Tertiary syphilis in HIV-uninfected and HIV-infected patients is vanishingly rare. This is most likely due to early treatment of cases of primary and secondary syphilis. There is rapid progression to tertiary syphilis in HIV-infected patients. Case Presentation A 49-year-old woman diagnosed with HIV Type 1 infection and cluster of differentiation 4 (CD4) count of 482 presented with a four-week history of multiple crusted plaques, nodules, and ulcers on her face, arms, and abdomen. Her past history revealed red painful eyes six months prior to this presentation. She had generalized lymphadenopathy, no alopecia, and no palmar-plantar or mucosal lesions. There were no features suggestive of secondary syphilis. Neurological examination was normal. Her rapid plasma reagin test was positive to a titer of 64. She was treated with Penicillin G 20 mu IVI daily for 2 weeks. Conclusion Penicillin remains the treatment of choice in syphilitic infected HIV negative and HIV-infected individuals. In neurosyphilis, the dose of Penicillin GIVI is 18–24 mu daily for 10–14 days. This case report demonstrates the importance of excluding syphilis in any HIV-infected patient.
Highlights
Human immunodeficiency virus (HIV) and Treponema pallidum coinfection is relatively common and accounts for about 25% of primary and secondary syphilis
We present a 49-year-old female patient who had tertiary syphilis characterized by gummas and papillitis on a background of HIV coinfection
Uveitis, and other ocular manifestations of syphilis are common among human immunodeficiency virus- (HIV-)infected patients [3]
Summary
Human immunodeficiency virus and Treponema pallidum coinfection is relatively common and accounts for about 25% of primary and secondary syphilis [1]. Tertiary syphilis in the antibiotic era is rare and tertiary syphilis in human immunodeficiency virus- (HIV-) uninfected and HIV-infected patients is vanishingly rare. This is most likely due to the judicious use of antibiotics and early treatment of cases of primary and secondary syphilis. The standard of care for syphilis is penicillin. We present a 49-year-old female patient who had tertiary syphilis characterized by gummas and papillitis on a background of HIV coinfection
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