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Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma.
Am J Case Rep. 2018 Mar 04; 19:238-243.AJ

Abstract

BACKGROUND

Syphilis is a sexually transmitted disease caused by the pathogen Treponema pallidum. Prevalence continues to rise, especially among men who have sex with men (MSM). Due to changes in patterns of sexual activity, manifestations of the disease are highly variable. CASE REPORT A 27-year-old male visited the hospital for a low-grade fever and tender 5-cm mass in the right side of his neck. His right tonsil was swollen and covered with a white coating. Levofloxacin was prescribed, but ineffective. The patient's levels of liver function enzymes increased gradually. Systemic magnetic resonance imaging (MRI) revealed bilateral cervical lymphadenopathy with right predominance, a right pulmonary nodule, and a periportal lymph node, suggestive of malignant lymphoma. However, a biopsy of the right cervical lymph node showed nonspecific inflammation. Preoperative rapid plasma reagin (RPR) and T. pallidum latex agglutination (TPLA) tests were positive. The patient was MSM and reported oral sex with many sexual partners. A diagnosis of secondary syphilis was made. Oral amoxicillin was effective, and all symptoms other than periportal lymph node resolved.

CONCLUSIONS

Tonsillitis, cervical lymphadenopathy, and lung lesions can be manifestations of secondary syphilis. A detailed history, pathology, and serology are crucial for diagnosis.

Authors+Show Affiliations

Department of Hematology, Japan Community Healthcare Organization (JCHO), Tokyo Yamate Medical Center, Tokyo, Japan.Department of Diagnostic Pathology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.Department of Hematology and Oncology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.Department of Pathology, Japan Community Healthcare Organization (JCHO), Tokyo Yamate Medical Center, Tokyo, Japan.Department of Hematology, Japan Community Healthcare Organization (JCHO), Tokyo Yamate Medical Center, Tokyo, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29502129

Citation

Komeno, Yukiko, et al. "Secondary Syphilis With Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma." The American Journal of Case Reports, vol. 19, 2018, pp. 238-243.
Komeno Y, Ota Y, Koibuchi T, et al. Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma. Am J Case Rep. 2018;19:238-243.
Komeno, Y., Ota, Y., Koibuchi, T., Imai, Y., Iihara, K., & Ryu, T. (2018). Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma. The American Journal of Case Reports, 19, 238-243.
Komeno Y, et al. Secondary Syphilis With Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma. Am J Case Rep. 2018 Mar 4;19:238-243. PubMed PMID: 29502129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma. AU - Komeno,Yukiko, AU - Ota,Yasunori, AU - Koibuchi,Tomohiko, AU - Imai,Yoichi, AU - Iihara,Kuniko, AU - Ryu,Tomiko, Y1 - 2018/03/04/ PY - 2018/3/5/entrez PY - 2018/3/5/pubmed PY - 2018/9/19/medline SP - 238 EP - 243 JF - The American journal of case reports JO - Am J Case Rep VL - 19 N2 - BACKGROUND Syphilis is a sexually transmitted disease caused by the pathogen Treponema pallidum. Prevalence continues to rise, especially among men who have sex with men (MSM). Due to changes in patterns of sexual activity, manifestations of the disease are highly variable. CASE REPORT A 27-year-old male visited the hospital for a low-grade fever and tender 5-cm mass in the right side of his neck. His right tonsil was swollen and covered with a white coating. Levofloxacin was prescribed, but ineffective. The patient's levels of liver function enzymes increased gradually. Systemic magnetic resonance imaging (MRI) revealed bilateral cervical lymphadenopathy with right predominance, a right pulmonary nodule, and a periportal lymph node, suggestive of malignant lymphoma. However, a biopsy of the right cervical lymph node showed nonspecific inflammation. Preoperative rapid plasma reagin (RPR) and T. pallidum latex agglutination (TPLA) tests were positive. The patient was MSM and reported oral sex with many sexual partners. A diagnosis of secondary syphilis was made. Oral amoxicillin was effective, and all symptoms other than periportal lymph node resolved. CONCLUSIONS Tonsillitis, cervical lymphadenopathy, and lung lesions can be manifestations of secondary syphilis. A detailed history, pathology, and serology are crucial for diagnosis. SN - 1941-5923 UR - https://www.unboundmedicine.com/medline/citation/29502129/Secondary_Syphilis_with_Tonsillar_and_Cervical_Lymphadenopathy_and_a_Pulmonary_Lesion_Mimicking_Malignant_Lymphoma_ L2 - https://www.amjcaserep.com/download/index/idArt/907127 DB - PRIME DP - Unbound Medicine ER -