International Journal of STD & AIDS > Volume 19, Number 1 > Pp. 65-66

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CASE REPORT

Early syphilitic hepatitis in an immunocompetent patient: really so uncommon?

P Noto MD ^*, F Del Nonno MD , S Licci MD , P Chinello MD ^* and N Petrosillo MD ^*

^* Clinical Department, 2nd Infectious Diseases Division; Department of Pathology, National Institute for Infectious Diseases ‘L Spallanzani’, Via Portuense, 292 – 00149 Rome, Italy

Correspondence to: Dr Nicola Petrosillo Email: petrosillo{at}inmi.it

The incidence of syphilis has increased substantially over the past years, particularly in men who have sex with men. The clinical manifestations of syphilis are variable and liver involvement is uncommon, but may occur at any stage of the disease. We report a case of early syphilitic hepatitis (ESH) in an immunocompetent patient referring multiple bisexual exposures, who presented at admission with jaundice, tiredness, an ulcerated genital lesion and an increase of liver aminotransferases. During his hospital stay, he developed a skin rash, and serology for syphilis was found positive. Our case report strengthens the need to take into consideration the diagnosis of ESH in all patients with unexplained liver enzyme increase and epidemiological data of unsafe sexual exposures. Indeed, an early recognition of the clinical manifestations of syphilis can lead to a prompt treatment, and allows the prevention of the transmission of this disease to other individuals.

Key Words: acute hepatitis • syphilis • immunocompetent patient

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