Relapsing Syphilis with an Abnormal Timeline and Presentation in an HIV- Negative Patient

Zackary Tareky, Fadi Al Akhrass, Christina Al Akhrass, Jack Wilson II, Rimsha Afzal, Ling Lin, Lina Abdallah, Joseph Bott, Pratyusha Veldhi and Madison Calhoun

University of Pikeville, Kentucky College of Osteopathic Medicine, USA Pikeville Medical Center, USA University of Louisville School of Medicine, USA

^*Correspondance to: Zackary Tareky 

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Abstract:

Despite the advent of effective and curable penicillin, the incidence of syphilis in the United States has returned to alarming levels. Consequently, the Centers for Disease Control and Prevention (CDC) 2022 Sexually Transmitted Infection (STI) surveillance report underscored that syphilis must be a public health priority. We report a case of a 52-year-old male, HIV-negative, who presented with laboratory-confirmed neurosyphilis, ocular syphilis and typical secondary-stage cutaneous syphilis. The patient was previously diagnosed with primary syphilis almost 20 years ago and was treated with the proper regimen of benzathine penicillin G. About 25% of patients with secondary syphilis will experience a relapse, usually within the first year of infection. There have been cases of relapsed syphilis in the past, however, these relapses tend to be because of either lack of treatment or treatment failure which is associated with being HIV positive or immunocompromised in some form. Typically, patients would have experienced a dormant period and then progression to tertiary syphilis. However, it is unreported to present with a secondary syphilitic rash at a timeframe of 20 years from the onset of infection, without evidence of reinfection.

Keywords:

Secondary syphilis; Relapsed syphilis; Syphilis reinfection; Immune competent syphilis; Treatment resistant syphilis; Penicillin G

Cite the Article:

Tareky Z, Al Akhrass F, Al Akhrass C, Wilson II J, Afzal R, Lin L, et al. Relapsing Syphilis with an Abnormal Timeline and Presentation in an HIVNegative Patient. Ann Clin Case Rep. 2024; 9: 2697..