Syphilitic hepatitis – a rare manifestation of a common disease
Gastroenterology and Hepatology from Bed to Bench,
26 January 2021
ABSTRACT: Syphilis is a sexual transmitted disease caused by Treponema pallidum and an underdiagnosed and underreported cause of acute hepatitis. In later years, reported cases of primary and secondary syphilis are increasing, mostly in men who have sex with men. Clinical manifestations of syphilis are very diverse, earning the name of “the great imitator”. It can virtually affect any organ. Nonetheless hepatic involvement is rare, but hepatic involvement can occur at any stage of the disease.
We present the case of a 41-year-old immunocompetent male, that presents to us with a cholestatic hepatitis and a diffuse erythematous rash with palmo-plantar affection. Patient had no history of primary syphilis. After throughout aetiologic study it was diagnosed with syphilitic hepatitis and treated with intramuscular Benzathine benzylpenicillin, with disappearance of the rash and normalization of liver enzymes after 3 months.
We would like to highlight that this aetiology should be considered in patients with unexplained elevation of liver enzymes (mainly cholestatic enzymes) and an epidemiologic context of unsafe sexual exposure.
Keywords: acute hepatitis, secondary syphilis, syphilitic hepatitis, immunocompetent patient, sexually transmitted infection
- acute hepatitis
- secondary syphilis
- syphilitic hepatitis
- immunocompetent patient
- sexually transmitted infection
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