Primary syphilis presenting as a painful unilateral inguinal lymphadenopathy, without cutaneous manifestations, in a 71-year-old Japanese man: A case report

Kenji Yorita, MD, PhD; Chikane Ito, MD; Ai Fujioka, MD; Keisuke Kashiwagi, MD; Hiromichi Yamai, MD, PhD; Kimiko Nakatani, MD; Tatsuya Kumon, MD

Radiology Case Reports (Jan 2023)

Primary syphilis presenting as a painful unilateral inguinal lymphadenopathy, without cutaneous manifestations, in a 71-year-old Japanese man: A case report

Kenji Yorita, MD, PhD,
Chikane Ito, MD,
Ai Fujioka, MD,
Keisuke Kashiwagi, MD,
Hiromichi Yamai, MD, PhD,
Kimiko Nakatani, MD,
Tatsuya Kumon, MD

Affiliations

Kenji Yorita, MD, PhD: Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan; Corresponding author.
Chikane Ito, MD: Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan; Department of Dermatology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku-shi, Kochi 783-8505, Japan
Ai Fujioka, MD: Department of Dermatology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
Keisuke Kashiwagi, MD: Department of Plastic Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
Hiromichi Yamai, MD, PhD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
Kimiko Nakatani, MD: Department of Radiology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
Tatsuya Kumon, MD: Department of Surgery, Noichi Central Hospital, 555-18 Higashino, Noichi-cho, Konan-shi, Kochi 781-5213, Japan

Journal volume & issue: Vol. 18, no. 1
pp. 280 – 284

Abstract

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Syphilitic infection is usually observed in young patients, and the first stage of the disease (primary syphilis) is characterized by painless cutaneous and lymph node lesions. Herein, we describe a 71-year-old Japanese man with primary syphilis that presented as unilateral inguinal lymphadenopathy without skin lesions. Originally, an incarcerated hernia was clinically suspected. The lymph node pathologically showed suppurative lymphadenitis with vague granulomas; immunohistochemistry was highly suggestive of a syphilitic infection. Primary syphilis was confirmed by positive serological tests. Syphilitic infection should be included in the clinicopathological differential diagnoses for patients with inguinal lymphadenopathy, even in elderly patients without skin lesions.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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