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Case report
Atypical case of syphilitic hepatitis
  1. Elliott Goldberg1,
  2. Bathai Edwards1 and
  3. Kaleigh Krill2
  1. 1Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
  2. 2Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
  1. Correspondence to Elliott Goldberg; elliottgold96{at}gmail.com

Abstract

A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1 week of jaundice, abdominal pain, cough and headache. Examination revealed scleral icterus, right upper quadrant tenderness and hepatomegaly. Initial investigations revealed hyperbilirubinaemia and elevated transaminases. Serum studies were positive for antinuclear antibodies, antimitochondrial antibodies, and herpes simplex virus IgM. Despite being started on intravenous acyclovir, his bilirubin and transaminase levels continued to rise. He was subsequently tested for syphilis given his maculopapular rash on the soles of his feet and it returned positive. He improved clinically with the initiation of penicillin. In this case, we will discuss the presentation, diagnosis and treatment of syphilitic hepatitis.

  • hepatitis other
  • infectious diseases
  • syphilis

https://doi.org/10.1136/bcr-2020-237851

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    Footnotes

    • Contributors EG and KK cared directly for the patient and planned the report. EG and BE designed the manuscript and interpreted the case. All authors reviewed and edited the final draft of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.