When the Sailor's Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Rachel Dawson; Davena Zhang; Navid Salahi; Daniel Kashani

doi:10.7759/cureus.22802

When the Sailor's Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Cureus. 2022 Mar 3;14(3):e22802. doi: 10.7759/cureus.22802. eCollection 2022 Mar.

Authors

Rachel Dawson¹, Davena Zhang², Navid Salahi³, Daniel Kashani⁴

Affiliations

¹ Medical School, St. George's University, Saint George, GRD.
² Internal Medicine, State University of New York Downstate Medical Center, New York, USA.
³ Pathology, State University of New York Downstate Medical Center, New York, USA.
⁴ Hospital Internal Medicine, Mayo Clinic, Rochester, USA.

Abstract

Secondary syphilis has variable systemic manifestations, impersonating the presentation of more common pathologies, deceiving clinicians, and creating a difficult-to-diagnose patient. The case discussed combines hepatic syphilis with an uncommon syphilitic dermatologic presentation in a patient with HIV and a history of hepatitis A and B. Due to the challenge of diagnosis, the relative ease of confirming the diagnosis with serological assays, and reversibility of hepatic injury, the inclusion of syphilitic hepatitis on a differential diagnosis of hepatitis is warranted.

Keywords: biopsy; hepatitis; hiv; rash; syphilis.

Publication types

Case Reports