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The Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator

Nicole Finney, MPH*, Eli Soyfer, MS*, Rory Schwan, MD* and Lindsey C Spiegelman, MD, MBA*

*University of California, Irvine, Department of Emergency Medicine, Orange, CA

Correspondence should be addressed to Lindsey C Spiegelman, MD, MBA at lspiegel@hs.uci.edu

DOI: https://doi.org/10.21980/J8R93N Issue 8:2
Visual EMInfectious Disease
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ABSTRACT:

Syphilis is a progressive sexually transmitted infection that has a wide variety of presentations depending on the disease stage. These variable presentations can make it difficult to differentiate syphilis from other diseases. While tertiary syphilis is less common in the United States compared to primary or secondary syphilis, recognition of the varied manifestations of advanced syphilis can help providers accurately diagnose this disease to help prevent continued spread. In this case report, we present a patient with a history of bilateral palmar wounds. The patient had presented to multiple emergency departments without a diagnosis of syphilis. Upon subsequent emergency department visits, the patient was diagnosed with tertiary syphilis, started on a course of penicillin, and evaluated by dermatology. However, the patient left against medical advice prior to further evaluation and treatment. From this case report, we have learned the importance of considering tertiary syphilis gummas in the differential diagnosis of atypical skin wounds.

Topics:

Sexually transmitted infection (sti), syphilis, tertiary syphilis, gummas, dermatologic lesions.

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