Abstract
Syphilis among HIV-infected patients continues to be a public health concern, especially in men who have sex with men. The clinical manifestations of syphilis are protean; syphilitic hepatitis is an unusual complication that can occur at any stage of the disease. We report a case of an HIV-infected male who presented with systemic symptoms and liver lesions highly suggestive of lymphoma and was proven to have syphilitic hepatitis by liver biopsy. Our case reinforces the importance of recognizing syphilis as a possible cause of unexplained abnormal liver enzymes and/or hepatic lesions in HIV-infected patients.
Highlights
Syphilis among HIV-infected patients continues to be a public health concern
We present a case of an HIV positive male with hepatic lesions suggestive of lymphoma who was eventually diagnosed with syphilitic hepatitis after liver biopsy
Syphilis/HIV coinfection accounts for approximately 25% of the cases of primary and secondary syphilis reported in the United States [5]
Summary
Liver involvement with early syphilis is an infrequently recognized complication, it is an especially challenging diagnosis in HIV-infected individuals who often have abnormal liver function tests from any one of multiple potential causes [1]. Coexisting conditions such us hepatitis C, hepatitis B, mycobacterial infection, and neoplastic diseases as lymphoma or Kaposi’s sarcoma may cause liver enzymes abnormalities in this population, as well as medications, substance abuse, and fatty liver disease. Treponema pallidum is known to cause hepatitis, but relatively few case reports have been published of hepatic involvement in early syphilis in HIV-infected patients [1,2,3,4]. We present a case of an HIV positive male with hepatic lesions suggestive of lymphoma who was eventually diagnosed with syphilitic hepatitis after liver biopsy
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