amoxicillin-potassium-clavulanate-combination and Syphilis

Syphilis is a sexually transmitted systemic infection caused by Treponema pallidum. We report a case of a heterosexual, HIV-positive man who presented with secondary syphilis and a lung abscess. A bacterial lung abscess was suspected and a computed tomography-guided percutaneous needle aspiration of the lung abscess was performed. Direct pulmonary involvement by T. pallidum was suggested by a positive PCR result on the aspirated fluid specimen. The clinical signs of secondary syphilis improved, and the lung abscess was resolved after treatment with benzathine penicillin G and amoxicillin-clavulanate. The final diagnosis was secondary pulmonary syphilis. Few reports of secondary syphilis with pulmonary involvement have been reported to date.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chest Pain; HIV Infections; Humans; Lung; Lung Abscess; Male; Penicillin G Benzathine; Polymerase Chain Reaction; Syphilis; Syphilis Serodiagnosis; Tomography, X-Ray Computed; Treatment Outcome; Treponema pallidum

The incidence of sexually transmitted diseases recently increased in the United States and Europe due to migration, increase in high-risk behavior, and abandonment of safer sex practices at the advent of anti-retroviral combination therapy for human immunodeficiency virus infection. This article presents four cases of primary oral anti perioral syphilis with differential diagnoses. It is important to bear this reappearing infection in mind to avoid latent infection. Resembling common oral infections, the primary affect disappears spontaneously, and the infection enters the second stage. The patient remains infected, may further spread the disease, and risks severe organ damage from long-standing infection. The antibiotic cure is inexpensive and safe and spares the patient mucous patches and gumma residuals, apart from severe general sequelae such as thoracic aorta aneurysm and neurosyphilis. However, compliance problems jeopardize clinical and serologic follow-up. The growing syphilis incidence prompts the commemoration of Dr Moriz Kaposi and his dispositive 1891 book Pathology and Therapy of the Syphilis. Moriz Kaposi is acknowledged as one of the heads of the Vienna School of Dermatology, a superb clinician, and renowned teacher.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Dermatitis, Perioral; Diagnosis, Differential; Female; History, 19th Century; Humans; Male; Mouth Diseases; Mouth Mucosa; Palate, Hard; Syphilis; Syphilis, Cutaneous