Outcome
His syphilis serology was positive
– Initial IgG ELISA test positive
– TPHA positive
– IgM positive and RPR (128) positive confirm recent infection
All other screening tests (including viral hepatitis and HIV test) were unremarkable, hence a diagnosis of secondary syphilis causing hepatitis was made. Further examination revealed a healing chancre on the shaft of his penis and pustules around the anu.
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Refferences
- Health protection agency. http://www.hpa.org.uk/webw/HPAweb&Page &HPAwebAutoListName/Page/1191942128110?p=1191942128110 up dated 7th April 2008.
- Health Protection Surveillance Centre. http://www.ndsc.ie/hpsc/A-Z/ HepatitisHIVAIDSandSTIs/SexuallyTransmittedInfections/Syphilis/ Factsheet/.
- David Wilks, Mark Farrington and David Rubenstein. The infectious Disease Manual second edition. 2003
- Sergio Sabbatani, Roberto Manfredi, Luciano Attard, Nunzio Salfi, Francesco Chiodo. Secondary Syphilis Presenting with Acute Hepatic Involvement in a Patient with Undiagnosed HIV Disease. AIDS Patient Care and STDs. September 1, 2005, 19(9): 545-549. doi:10.1089/ apc.2005.19.545
- P Noto, F Del Nonno, S Licci, et al. Early syphilitic hepatitis in an immunocompetent patient: really so uncommon? Int J STD AIDS 2008; 19: 65–66.
- V. N. Sehgal and V.L. Rege. Malignant syphilis and hepatitis. Brit. J. vener. Dis 1974; 50: 237.
- V Pope. Use of treponemal tests to screen for syphilis. Journal of Infectious Diseases 2004; 21: 399–402.
- Syphilis Testing Algorithms Using Treponemal Tests for Initial Screening. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5732a2.htm
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