Syphilis is a sexually transmitted systemic infection caused by Treponema pallidum. We report a case of a heterosexual, HIV-positive man who presented with secondary syphilis and a lung abscess. A bacterial lung abscess was suspected and a computed tomography-guided percutaneous needle aspiration of the lung abscess was performed. Direct pulmonary involvement by T. pallidum was suggested by a positive PCR result on the aspirated fluid specimen. The clinical signs of secondary syphilis improved, and the lung abscess was resolved after treatment with benzathine penicillin G and amoxicillin-clavulanate. The final diagnosis was secondary pulmonary syphilis. Few reports of secondary syphilis with pulmonary involvement have been reported to date.
LeeyaphanCJiamtonSPrasertworonunNet al.
Clinical and epidemiological characteristics of patients with syphilis: 5 year-case study from Thailand. J Med Assoc Thai2014;
97: 963–968.
2.
DavidGPerpointTBoibieuxAet al.
Secondary pulmonary syphilis: report of a likely case and literature review. Clin Infect Dis2006;
42: e11–e15.
3.
KimSJLeeJHLeeESet al.
A case of secondary syphilis presenting as multiple pulmonary nodules. Kor J Intern Med2013;
28: 231–235.
4.
ColemanDLMcPheeSJRossTFet al.
Secondary syphilis with pulmonary involvement. West J Med1983;
138: 875–878.
5.
ElzoukiANAl-KawaazMTafeshZ.Secondary syphilis with pleural effusion: case report and literature review. Case Rep Infect Dis2012;
2012: 409896.
6.
VasudevanBVermaRPragasamVet al.
A rare case of secondary syphilis manifesting as immune reconstitution syndrome in an HIV-positive patient. J Int Assoc Provid AIDS Care2013;
12: 380–383.
7.
BiroLHillACKuflikEG.Secondary syphilis with unusual clinical and laboratory findings. JAMA1968;
206: 889–891.
8.
SchibliHHarmsM.Tumour-like pulmonary lesion in secondary syphilis: a case report. Br J Vener Dis1981;
57: 367–371.
9.
GeerLLWarshauerDMDelanyDJ.Pulmonary nodule in secondary syphilis. Australas Radiol1985;
29: 240–242.
10.
KurumajiYKatohTOhtakiNet al.
A case of secondary syphilis with a solitary pulmonary lesion. Dermatologica1987;
174: 23–27.
SouzaASJrSouzaASZanettiGet al.
A skin rash with multiple pulmonary nodules. Eur Respir Rev2015;
24: 682–683.
17.
JenyFFargelatALaurent-RousselSet al.
Pulmonary consolidations due to secondary syphilis with positive bronchial washing immunohistochemistry. Am J Respir Crit Care Med2016;
193: 1061–1062.
18.
RigantiJMartinMTorreACet al.
Secondary syphilis with pulmonary involvement. JEADV2016;
30: e175–e238.
19.
KhatriASkalweitMJ.A rare case of immune reconstitution inflammatory syndrome presenting as secondary syphilis. Int J STD AIDS2014;
26: 749–751.
20.
Frunza-StefanSAcharyaGKazlouskayaVet al.
Immune reconstitution inflammatory syndrome associated with secondary syphilis. Int J STD AIDS2016;
28: 302–305.
HayPETamFWKitchenVSet al.
Gummatous lesions in men infected with human immunodeficiency virus and syphilis. Genitourin Med1990;
66: 374–379.
23.
YoonYKKimMJChaeYSet al.
Cerebral syphilitic gumma mimicking a brain tumor in the relapse of secondary syphilis in a human immunodeficiency virus-negative patient. J Kor Neurosurg Soc2013;
53: 197–200.
24.
Centurion-LaraACastroCShafferJMet al.
Detection of Treponema pallidum by a sensitive reverse transcriptase PCR. J Clin Microbiol1997;
35: 1348–1352.
25.
KouznetsovAVWeisenseelPTrommlerPet al.
Detection of the 47-kilodalton membrane immunogen gene of Treponema pallidum in various tissue sources of patients with syphilis. Diagn Microbiol Infect Dis2005;
51: 143–145.
26.
KingstonMFrenchPGohBet al.
UK national guidelines on the management of syphilis 2008. Int J STD AIDS2008;
19: 729–740.
27.
TanizakiRNishijimaTAokiTet al.
High-dose oral amoxicillin plus probenecid is highly effective for syphilis in patients with HIV infection. Clin Infect Dis2015;
61: 177–183.
