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A 44-yo♂️, HIV +, CD4 cell count of 86/mL, viral load of 35,900 copies/mL: a 1-month history of fevers and pruritic blackish-brown lamellated plaques on the limbs and scalp.
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👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology
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👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology
A RPR titer of 1:32.
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.
MALIGNANT SYPHILIS
2/4
#microbiology #dermpath #RareInfection
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.
MALIGNANT SYPHILIS
2/4
#microbiology #dermpath #RareInfection
Malignant #syphilis:
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4
#primarycare #MedTwitter #Awareness
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4
#primarycare #MedTwitter #Awareness
The patient declined:
- lumbar puncture to evaluate for neurosyphilis
-penicillin desensitization (history of anaphylaxis to penicillin)
After a 2-week of ceftriaxone, the skin lesions & fevers abated
At a 3-month: RPR titer 1:2
4/4
doi:10.1056/NEJMicm2213894
#CaseReport #Doctor
- lumbar puncture to evaluate for neurosyphilis
-penicillin desensitization (history of anaphylaxis to penicillin)
After a 2-week of ceftriaxone, the skin lesions & fevers abated
At a 3-month: RPR titer 1:2
4/4
doi:10.1056/NEJMicm2213894
#CaseReport #Doctor
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