[Sarcoidosis-like granulomatosis revealing a tertiary syphilis].
Numerous disorders can cause a systemic granulomatosis. We report a patient who presented a biopsy proven granulomatous skin eruption, fever, and atypical thoracic pain. Electrocardiogram showed a first-degree atrioventricular heart bloc. During follow-up he developed a panuveitis and oral corticosteroids were started. A diagnosis of systemic sarcoidosis was considered. Because of unfavourable ophthalmologic outcome, investigations were enlarged and revealed a highly positive serology for syphilis and VDRL both in serum and cerebrospinal fluid. Clinical outcome with penicillin G therapy was favorable. This observation reminds us the clinical polymorphism of syphilis, which can be presented as a systemic granulomatosis.
Hervier
B
B
Service de médecine interne, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex, France. baptiste.hervier@chu-nantes.fr
Wastiaux
H
H
Freour
T
T
Masseau
A
A
Corvec
S
S
Armingeat
T
T
Hamidou
M
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D054537:Atrioventricular Block / Q000175:diagnosis / Q000209:etiology; D001706:Biopsy; D004562:Electrocardiography; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008297:Male; D015864:Panuveitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D010400:Penicillin G / Q000627:therapeutic use; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000473:pathology; D013587:Syphilis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013588:Syphilis Serodiagnosis; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D010400:Penicillin G