Extracutaneous atypical syphilis in HIV-infected patients

Abstract

Introduction and objetive: We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients.

Methods: Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analysed.

Results: A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalised adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them.

Conclusions: Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most freqent.

Keywords: Hombres que tienen sexo con hombres; Human immunodeficiency virus; Infecciones de transmisión sexual; Men who have sex with men; Sexually transmitted infections; Syphilis; Sífilis; Treponema pallidum; Virus de la inmunodeficiencia humana.