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Localised cervical lymphadenopathy: a rare presenting sign of syphilis
  1. Elisa Hendrika Adriaansens1,
  2. Marieke E C van Winden2 and
  3. Peter van Wijngaarden1
  1. 1Internal Medicine, Amphia Ziekenhuis Locatie Molengracht, Breda, The Netherlands
  2. 2Dermatology, Radboudumc, Nijmegen, The Netherlands
  1. Correspondence to Dr Peter van Wijngaarden; pvanwijngaarden{at}amphia.nl

Abstract

Recognising syphilis can be challenging due to enormous variability in disease presentation. We present a case of 56-year-old female patient, without any medical history, with unilateral cervical lymphadenopathy and night sweats since 3 weeks. Initial differential diagnosis consisted of infectious disease, lymphoproliferative disease and autoimmune disease. Despite considerable diagnostic efforts, including serological tests for common infectious diseases, a CAT scan and histologic examination, no diagnosis was found. After reconsideration, serologic testing for syphilis was performed and was positive. Hereby, the final diagnosis of syphilis was made. Neurosyphilis and HIV coinfection were ruled out before treatment with benzylpenicillin was initiated. After which our patient made a full recovery. Treatment delay could have been considerably diminished if the localised lymphadenopathy was recognised as possible syphilitic disease. In future cases this could not only prevent further dissemination and potential morbidity in the individual patient as well as further emergence within the population.

  • infectious diseases
  • syphilis

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Footnotes

  • Contributors EHA was responsible for drafting this case report. MECvW was responsible for revising this case report. PvW was responsible for the acquisition and interpretation of the data, final revision and approval 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.

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

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