[Non-cutaneous manifestations of secondary syphilis].
BACKGROUND
The usual presentation of secondary syphilis is with cutaneous and mucosal symptoms. However, systematic symptoms can also occur. The purpose of this study was to describe non-mucocutaneous manifestations of secondary syphilis.


METHODS
Patients from the Infectious Diseases Department of Tourcoing Hospital in whom secondary syphilis was diagnosed between January 2000 and December 2006 were enrolled in this study. Patients with secondary syphilis had the typical cutaneous and mucosal symptoms and a VDRLgreater than or equal to one quarter (or a fourfold increase in the VDRL if previously positive).


RESULTS
Seventy-seven patients presenting a total of 80 cases of secondary syphilis were enrolled, 50 of whom were HIV-positive. Of these patients, 21 (26.3 p. 100) had neurological symptoms with three cases (3.8 p. 100) of uveitis, four (5 p. 100) of papillitis, two (2.5 p. 100) of retinitis and one (1.25 p. 100) of otosyphilis. In 14 of these 21 patients (67 p. 100), lumbar puncture was performed, confirming the diagnosis of neurosyphilis in six cases. Three patients (3.8 p. 100) had diarrhoea, four (5 p. 100) had abdominal pain and six (7.5 p. 100) had hepatomegaly. Seven (11.5 p. 100) patients had alanine aminotransferase levels above twice the normal upper limit and two above 10 times the normal upper limit. Three patients had bone pain and in one patient, osteitis was confirmed by technetium and gallium scintigraphy (osteolysis).


CONCLUSIONS
In patients with secondary syphilis, clinicians should search for non-mucocutaneous symptoms. In the presence of these symptoms, appropriate syphilis treatment should be initiated.
Dumortier
C
C
Service régional et universitaire des maladies infectieuses et du voyageur, centre hospitalier Dron, 135, rue du Président-Coty, B.P. 619, 59208 Tourcoing cedex, France. carolined01@hotmail.com
Alcaraz
I
I
Tone
A
A
Burban
S Deuffic
SD
Delesalle
F
F
Maryse
F
F
Melliez
H
H
Viget
N
N
Baclet
V
V
Pavel
S
S
Ajana
F
F
Yazdanpanah
Y
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002308:Cardiolipins; D002784:Cholesterol; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005128:Eye Diseases / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis; D006679:HIV Seropositivity; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis; D010000:Osteitis / Q000175:diagnosis / Q000209:etiology; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000209:etiology; D010713:Phosphatidylcholines; D011446:Prospective Studies; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D013129:Spinal Puncture; D013587:Syphilis / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D013588:Syphilis Serodiagnosis / Q000379:methods
D002308:Cardiolipins; D010713:Phosphatidylcholines; C054448:VDRL antigen; D002784:Cholesterol