Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis

Syphilis presents with various clinical manifestations, making diagnosis challenging. We report an atypical case involving a 58-year-old immunocompetent man with a history of penile lesions. He exhibited an ulcerated skin lesion in the right temporal region, oral condyloma, lymphadenopathy, and an a...

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Main Authors: Raul Marquez, Taha Shaikh, Badrunnisa Hanif
Format: Article
Language:English
Published: American College of Physicians 2025-02-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0915
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author Raul Marquez
Taha Shaikh
Badrunnisa Hanif
author_facet Raul Marquez
Taha Shaikh
Badrunnisa Hanif
author_sort Raul Marquez
collection DOAJ
description Syphilis presents with various clinical manifestations, making diagnosis challenging. We report an atypical case involving a 58-year-old immunocompetent man with a history of penile lesions. He exhibited an ulcerated skin lesion in the right temporal region, oral condyloma, lymphadenopathy, and an abdominal wall mass. Despite inconclusive histopathologic findings of the skin lesion biopsy, a diagnosis of nonprimary syphilis was made based on strong clinical evidence, a reactive fluorescent treponemal antibody assay, and an elevated rapid plasma reagin titer. The patient showed a remarkable response to intravenous penicillin G therapy. This case report highlights the importance of early recognition and management of atypical syphilis presentations.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-ae8720c7eb92444686e4cefeb2060eed2025-08-20T03:18:48ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-02-014210.7326/aimcc.2024.0915Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of SyphilisRaul Marquez0Taha Shaikh1Badrunnisa Hanif21Department of Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, Nevada1Department of Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, Nevada1Department of Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NevadaSyphilis presents with various clinical manifestations, making diagnosis challenging. We report an atypical case involving a 58-year-old immunocompetent man with a history of penile lesions. He exhibited an ulcerated skin lesion in the right temporal region, oral condyloma, lymphadenopathy, and an abdominal wall mass. Despite inconclusive histopathologic findings of the skin lesion biopsy, a diagnosis of nonprimary syphilis was made based on strong clinical evidence, a reactive fluorescent treponemal antibody assay, and an elevated rapid plasma reagin titer. The patient showed a remarkable response to intravenous penicillin G therapy. This case report highlights the importance of early recognition and management of atypical syphilis presentations.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0915
spellingShingle Raul Marquez
Taha Shaikh
Badrunnisa Hanif
Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis
Annals of Internal Medicine: Clinical Cases
title Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis
title_full Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis
title_fullStr Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis
title_full_unstemmed Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis
title_short Unmasking “The Great Imitator”: A Case Report of a Rare Presentation of Syphilis
title_sort unmasking the great imitator a case report of a rare presentation of syphilis
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.0915
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