Colitis and gastroparesis associated with syphilis in an HIV-infected person with an undetectable viral load.
We present a patient with fully controlled HIV disease and a normal CD4 count whose initial treatment for syphilis failed. Biopsy-proven syphilitic colitis and severe gastroparesis developed, requiring the insertion of a temporary percutaneous gastrostomy tube. The patient responded to a course of high-dose aqueous crystalline penicillin followed by doxycycline, and he completely recovered. The occurrence of failure of conventional syphilis treatment in HIV-infected patients is discussed.
Gamenthaler
Andrew
A
Department of Surgery, Memorial University Medical Center, Savannah, Georgia, USA.
Moon
Naem
N
Lucero
Salina
S
Miroshnikova
Tatiana
T
Giron
Jose A
JA
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003092:Colitis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D018589:Gastroparesis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D005774:Gastrostomy; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D013587:Syphilis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000302:isolation & purification; D019562:Viral Load
D000900:Anti-Bacterial Agents; D010406:Penicillins; D004318:Doxycycline