title: Secondary syphilis presenting with acute severe hepatic involvement in a patient with undiagnosed HIV disease.
abstract: A case report of acute, massive, prolonged hepatitis related to secondary syphilis in a patient with undiagnosed HIV infection is described together with possible pathogenetic mechanisms. This is a rare occurrence in resource-rich countries in the era of antibiotics. The impaired immune response and the dysregulation of the cytokine network may have played a role in mediating this severe expression of HIV-associated secondary syphilis. An apparently unexplained acute hepatitis should deserve accurate screening for sexually transmitted diseases, including syphilis and HIV infection.
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Bologna "Alma Mater Studiorum," S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Sabbatani
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.forename: Luciano
authors.initials: L
authors.lastname: Attard
authors.forename: Nunzio
authors.initials: N
authors.lastname: Salfi
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiodo
mesh_terms: D000328:Adult; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008107:Liver Diseases / Q000209:etiology* / Q000473:pathology; D008297:Male; D013587:Syphilis / Q000150:complications*