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Inicio Medicina Clínica (English Edition) Extracutaneous atypical syphilis in HIV-infected patients
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Vol. 149. Issue 11.
Pages 488-492 (December 2017)
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Vol. 149. Issue 11.
Pages 488-492 (December 2017)
Brief report
Extracutaneous atypical syphilis in HIV-infected patients
Sífilis atípica extracutánea en pacientes con infección por VIH
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Paula Prietoa, Arkaitz Imaza,
Corresponding author
aimaz@bellvitgehospital.cat

Corresponding author.
, Laura Calatayudb, Olga Garcíac, María Saumoya, Daniel Podzamczera
a Unidad de VIH y Enfermedades de Transmisión Sexual, Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
b Servicio de Microbiología, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
c Servicio de Oftalmología, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
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Table 1. Characteristics of patients.
Abstract
Introduction and objective

We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients.

Methods

Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analyzed.

Results

A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalized adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them.

Conclusions

Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most frequent.

Keywords:
Syphilis
Treponema pallidum
Human immunodeficiency virus
Sexually transmitted infections
Men who have sex with men
Resumen
Introducción y objetivo

Se describe una serie de casos de sífilis con presentaciones clínicas atípicas extracutáneas en pacientes con infección por VIH.

Métodos

Estudio observacional retrospectivo. Se analizaron todos los casos de sífilis diagnosticados en pacientes VIH+ en el período de junio de 2013 a junio de 2016 en un hospital terciario del área metropolitana de Barcelona.

Resultados

Se diagnosticaron 71 casos de sífilis, de los cuales 32 presentaron manifestaciones clínicas. De estos, 7 casos (un 9,8% del total y un 21,8% de los casos sintomáticos) tuvieron una presentación clínica atípica con afectación extracutánea, en forma de sífilis ocular (4), gástrica (uno), abscesos hepáticos múltiples (uno) y adenopatías generalizadas sin afectación cutánea (uno). Todos los pacientes fueron tratados con penicilina por vía intramuscular o intravenosa, con evolución clínica y serológica favorable.

Conclusión

En el 21,8% de los casos de sífilis sintomática en pacientes VIH+ se observaron presentaciones clínicas extracutáneas atípicas siendo la más frecuente la afectación ocular.

Palabras clave:
Sífilis
Treponema pallidum
Virus de la inmunodeficiencia humana
Infecciones de transmisión sexual
Hombres que tienen sexo con hombres

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