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A case of secondary syphilis presenting as multiple pulmonary nodules

2013; Korean Association of Internal Medicine; Volume: 28; Issue: 2 Linguagem: Inglês

10.3904/kjim.2013.28.2.231

2005-6648

Se Joong Kim, Jeong Hyeon Lee, Eung-Seok Lee, Il Hwan Kim, Hyung Joo Park, Chol Shin, Je Hyeong Kim,

Reproductive tract infections research

Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement.