Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature
Joint Authors
Baidoun, Firas
Al-Turk, Bashar
Perez-Downes, Julio
Isache, Carmen
Mohan, Girish
Perniciaro, Charles
Ali, Robert
Source
Case Reports in Infectious Diseases
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-05-29
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Syphilis is a sexually transmitted infection that remains fairly commonplace.
The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV), syphilis is now on a resurgence with sometimes curious presentations.
We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis.
Skin lesions were reminiscent of “malignant” syphilis.
CD4 count was 57 cells/μL.
RPR was elevated with 1 : 64 titer and positive confirmatory TP-PA.
Radiography of the limbs revealed polyostotic cortical irregularities corroborated on bone scintigraphy.
The patient had an unknown penicillin allergy and was unwilling to conduct a trial of penicillin-based therapy.
He was subsequently treated with doxycycline 100 mg twice daily for 6 weeks and commenced antiretroviral therapy, noting dramatic improvement in both the skin lesions and joint pains.
Unfortunately, he defaulted on follow-up, precluding serial RPR and bone imaging.
Penicillin allergies have proven to be quite a conundrum in such patients, without much recourse for alternative therapy.
Doxycycline with/without azithromycin is other options worth considering.
American Psychological Association (APA)
Ali, Robert& Perez-Downes, Julio& Baidoun, Firas& Al-Turk, Bashar& Isache, Carmen& Mohan, Girish…[et al.]. 2016. Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature. Case Reports in Infectious Diseases،Vol. 2016, no. 2016, pp.1-6.
https://search.emarefa.net/detail/BIM-1100987
Modern Language Association (MLA)
Ali, Robert…[et al.]. Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature. Case Reports in Infectious Diseases No. 2016 (2016), pp.1-6.
https://search.emarefa.net/detail/BIM-1100987
American Medical Association (AMA)
Ali, Robert& Perez-Downes, Julio& Baidoun, Firas& Al-Turk, Bashar& Isache, Carmen& Mohan, Girish…[et al.]. Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature. Case Reports in Infectious Diseases. 2016. Vol. 2016, no. 2016, pp.1-6.
https://search.emarefa.net/detail/BIM-1100987
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1100987