Mucocutaneous relapse during late latent syphilis as initial presentation of HIV infection
Luca Pipitò,
Irene Russotto,
Dalila Arena,
Cinzia Calà,
Antonio Cascio
Affiliations
Luca Pipitò
Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ''G D′Alessandro,'' University of Palermo, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
Irene Russotto
Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ''G D′Alessandro,'' University of Palermo, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
Dalila Arena
Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ''G D′Alessandro,'' University of Palermo, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
Cinzia Calà
Microbiology and virology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ''G D′Alessandro,'' University of Palermo, Palermo, Italy
Antonio Cascio
Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ''G D′Alessandro,'' University of Palermo, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy; Correspondence to: Infectious and Tropical Diseases Unit, AOUP P. Giaccone, Via del Vespro, 129, 90127 Palermo, Italy.
Syphilis is a re-emerging sexually transmitted infection. According to the definition, latent syphilis is characterized by seroreactivity without clinical manifestations. Here, we reported an atypical case of syphilis in a patient with HIV naïve to the antiretroviral treatment characterized by mucocutaneous relapse that occurred in the late latent stage. The patient reported his last sexual intercourse about 18 months ago and had self-healing genital and palmoplantar lesions more than 1 year before the presentation. He denied any other types of sexual relationship. He presented with mucocutaneous scattered lesions on his face, neck, palms, soles, penis, and scrotum. He was compliant with arthralgias, myalgias, asthenia, new onset stypsis, and mild anorectal pain. Testing for Syphilis and HIV returned positive. Opportunistic infections were excluded, and antiretroviral therapy with a bictegravir-based regimen was started. Syphilis was treated successfully with three doses of 2.4 million units of benzathine penicillin.
