Form Of Secondary Syphilis Research Articles

Lues Maligna in a Patient with Human Immunodeficiency Virus: Case Report and Review of the Literature

Syphilis is a sexually transmitted infection with rising incidence in recent years due to increased rates of highrisk sexual behaviors. Often called “the great imitator,” syphilis can have many different presentations in its various stages: latent, primary, secondary and tertiary. One form of secondary syphilis is ulceronodular syphilis, also known as lues maligna. We report a case of a 48-year-old Filipino man who presented with a diffuse, ulcerating, papular rash and was subsequently diagnosed concurrently with both lues maligna and human immunodeficiency virus.

A Nodular-Ulcerative Form of Secondary Syphilis in Aids

An uncommon variant in the pre-AIDS era, lues maligna is a nodular-ulcerative form of secondary syphilis. We present a case of a 41-year-old man with HIV infection who developed fever, chills, nausea, vomiting, right upper quadrant abdominal pain, weight loss, watery diarrhea, and a painless, nonpruritic rash. He had diffuse nodular-ulcerative lesions in various stages of development. He was found to have a CD4 count of 101 cells/mm 3 (22%), an HIV viral load of 2,735,060 copies/mL, and a positive rapid plasma reagin at 1:64. He was started on emtricitabine, tenofovir, and dolutegravir, as well as doxycycline. He was given benzathine penicillin 2.4 million units intramuscularly and within hours developed a Jarisch-Herxheimer reaction. Skin lesions showed signs of healing, and constitutional symptoms improved 48 hours later.

Abstract 31: Acute Febrile Acrodynia (1781-1966): Historical Cases Of Kawasaki Disease Before Kawasaki?

Infantile acrodynia is a mercurial reaction that can mimic the complete clinical picture of Kawasaki disease (KD), and is therefore considered a differential diagnosis for KD. Before the 1950s, acrodynia affected 1 in 500 children in industrialized nations. The recently formed pediatric community was fascinated by this new disease since the late 1800s, resulting from the child’s extreme irritability along with striking mucocutaneous changes such as the bright red, swollen hands and feet. Parents would initially report their child suffered from a sudden fever caused by an undetermined infection. Children were not typically seen in hospital until their case became protracted and the insidious symptoms of advanced acrodynia were apparent weeks later. In the 1950s, it was discovered that mercurial remedies such as teething powders were a cause of acrodynia, leading to their removal from the market. Physicians in the British Isles first reported acrodynia in the medical literature after the use of mercurials were extended from adult syphilitic patients to the generalized patient population in the late 1700s. Previously, these acute febrile mercurial reactions were mistaken as a form of secondary syphilis. During the early to mid-1900s, it was noted that syphilitic patients undergoing mercurial or arsenical treatment were more likely to develop arterial thromboses, particularly of the coronary arteries, leading to diagnoses of a unique polyarteritis nodosa. Sudden death in infantile acrodynia often results from secondary infections, arterial thromboses, and cardiac failure. Shortly after acrodynia became a rare pediatric ailment, KD was first observed by Kawasaki in 1961 and reported in 1967. This coincides with unprecedented increases of mercury pollution and seafood contamination in East Asia, resulting in Minamata disease outbreaks during the 1950s and 1960s in Japan. Outbreaks of Minamata disease have been observed among indigenous populations in Canada since the 1970s, while Canada has the highest rates of KD outside of East Asia or Hawaii. Temporal associations are seen with increases and reductions of thimerosal from routine pediatric vaccines and KD outbreaks in the US and Japan. KD may in part represent a modern re-emergence of infantile acrodynia.

FRAMBESIFORM SYPHILID

It is quite generally agreed that the early frambesiform syphilid is an uncommon form of secondary syphilis. Although Sauvages (1768), as quoted by Kolaczek 1 and others, is credited with the first description of this manifestation, few cases have been reported. Practically no attention has been paid to the matter in this country, and very little abroad. It has therefore been thought that a brief review of the condition would be a fitting accompaniment of this report of a case of frambesiform syphilid. REPORT OF A CASE2 G. D., 36 years of age, was a sea butcher. He had never been in the tropics. Eight weeks before coming under observation he had been cut while being shaved by a barber. Later, he noticed from three to four small growths on his chin, and one similar but larger lesion below the left corner of the mouth. There were several small