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Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma.
- Source :
-
The American journal of case reports [Am J Case Rep] 2018 Mar 04; Vol. 19, pp. 238-243. Date of Electronic Publication: 2018 Mar 04. - Publication Year :
- 2018
-
Abstract
- BACKGROUND Syphilis is a sexually transmitted disease caused by the pathogen Treponema pallidum. Prevalence continues to rise, especially among men who have sex with men (MSM). Due to changes in patterns of sexual activity, manifestations of the disease are highly variable. CASE REPORT A 27-year-old male visited the hospital for a low-grade fever and tender 5-cm mass in the right side of his neck. His right tonsil was swollen and covered with a white coating. Levofloxacin was prescribed, but ineffective. The patient's levels of liver function enzymes increased gradually. Systemic magnetic resonance imaging (MRI) revealed bilateral cervical lymphadenopathy with right predominance, a right pulmonary nodule, and a periportal lymph node, suggestive of malignant lymphoma. However, a biopsy of the right cervical lymph node showed nonspecific inflammation. Preoperative rapid plasma reagin (RPR) and T. pallidum latex agglutination (TPLA) tests were positive. The patient was MSM and reported oral sex with many sexual partners. A diagnosis of secondary syphilis was made. Oral amoxicillin was effective, and all symptoms other than periportal lymph node resolved. CONCLUSIONS Tonsillitis, cervical lymphadenopathy, and lung lesions can be manifestations of secondary syphilis. A detailed history, pathology, and serology are crucial for diagnosis.
- Subjects :
- Adult
Amoxicillin therapeutic use
Biopsy, Needle
Diagnosis, Differential
Humans
Immunohistochemistry
Latex Fixation Tests methods
Liver Function Tests methods
Lymphadenopathy pathology
Magnetic Resonance Imaging methods
Male
Neck pathology
Prognosis
Risk Assessment
Sexual Behavior
Solitary Pulmonary Nodule pathology
Tonsillitis drug therapy
Treatment Outcome
Lymphadenopathy diagnosis
Solitary Pulmonary Nodule diagnosis
Syphilis diagnosis
Syphilis drug therapy
Tonsillitis diagnosis
Treponema pallidum isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1941-5923
- Volume :
- 19
- Database :
- MEDLINE
- Journal :
- The American journal of case reports
- Publication Type :
- Academic Journal
- Accession number :
- 29502129
- Full Text :
- https://doi.org/10.12659/ajcr.907127