title: Syphilitic myositis: a case-based review.
abstract: To present the clinical and pathological findings in patients presenting with myositis caused by syphilis. The literature is reviewed, and pathophysiologic factors discussed. A 49-year-old Caucasian heterosexual male with a known history of stable human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection, developed progressive muscle weakness over 10 weeks. He discontinued his medications; however, he had on-going muscle symptoms. A muscle biopsy was performed, consistent with mild myositis. While on prednisone therapy, he developed panuveitis and vertigo. CSF studies were positive for syphilis (Treponema pallidum). He was started on appropriate antibiotic therapy with complete clinical resolution. This patient presented with myositis and panuveitis as a manifestation of acute onset of syphilis. Syphilis is an uncommon cause of myositis. In patients with HIV and/or HCV, the disease itself and side effects of the medications must be considered. As patients with HIV may have co-infections, syphilis must be considered, especially when unresponsive to traditional management.
authors.affiliation: Department of Medicine, University of Alberta, 562 Heritage Medical Research Center, University of Alberta, Edmonton, Alberta, Canada. eyacyshyn@ualberta.ca
authors.forename: Elaine
authors.initials: E
authors.lastname: Yacyshyn
authors.forename: Praveena
authors.initials: P
authors.lastname: Chiowchanwisawakit
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Emery
authors.forename: Jack
authors.initials: J
authors.lastname: Jhamandas
authors.forename: Lothar
authors.initials: L
authors.lastname: Resch
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Taylor
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000494:pharmacology; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness; D009220:Myositis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*; D013587:Syphilis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D014210:Treponema pallidum / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents