Overlapping Primary and Secondary Syphilis in a Bisexual Patient with Human Immunodeficiency Virus
Downloads
Background: Syphilis and HIV are diseases that can be transmitted through sexual contact. Bisexual groups have a higher potential for HIV and syphilis transmission. In syphilis patients who have been infected with HIV, secondary syphilis often occurs along with primary syphilis, which can be found 2-3 times more often than in those who are not infected by HIV. Case: A 24-year-old male with HIV who is a bisexual man, complained chancre on his scrotum and on the tip of the penis that was painless and also has condyloma lata around the anus. Dermatological examination revealed multiple papules, patches, and plaques. The serological results for VDRL and TPHA were reactive. Histopathology examination of skin plaque suggests secondary syphilis. The Patient was diagnosed with overlapping primary-secondary syphilis and given therapy with single-dose intramuscular injection of benzathine penicillin G. Discussion: Bisexual groups have a higher potential for HIV and syphilis transmission. In HIV patients, primary and secondary syphilis often overlap. This was due to changes in the immune system causing the spread of Treponema pallidum more quickly and slowing the healing of primary lesions. Conclusion: Overlapping of primary and secondary syphilis in bisexual patients with HIV is common; in addition, the appearance of skin lesions in secondary syphilis can resemble other diseases, so confirmation by histopathology examination needs to be done.
Indriatmi W. Sifilis. In: Sjaiful FD, Hanny N, Wresti I, Farida Z, Rasmia R, Satiti RP, editors. Infeksi Menular Seksual. 5th ed. Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2017.p 103-29.
Tuddenham SA, Zenilman JM. Syphilis. In: Kang S, Amagai M, Bruckner AK, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick’s Dermatology in General Medcine. 9th ed. New York: McGraw Hill Education; 2019. p.3145–72.
Jalili A, Mosleh M, Pfistershammer KG, Loewe R, Stingl G, Rieger A. Malignant Syphilis in a HIV Infected Patient. Sex Transm Dis; 42(4):223-5.
Daili SF, Indriatmi W, Wiweko SN, Dewi H, Tanudjaya F, Wignall S, et al. Pedoman Tata Laksana Sifilis untuk Pengendalian Sifilis di Layanan Kesehatan Dasar. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.
Dwi Puspawati, N.M., Suryawati, N.N., Sudarsa, P.S.S. A case of secondary syphilis with stage four HIV infection accompanied with tuberculous lymphadenitis in bisexual man. Intisari Sains Medis. 2020; 11(3): 938-41.
Liao M, Kang D, Jiang B, Tao X, Qian Y, Wang T, et al. Bisexual behavior and infection with HIV and syphilis among men who have sex with men along the east coast of China. AIDS Patient Care and STDs. 2011;25(11):683–91.
Vitasandy TD. Self-concept of bisexual men. Jurnal Psikologi. 2010; 3(2):1-7.
Centers for Diseases Controls and Preventions. CDC Analysis Provides New Look at Disproportionate Impact of HIV and Syphilis among US Gay and Bisexual Men. 2014. Available from:http://www.cdc.gov/nchhstp/newsroom/.html
Abara WE, Hess KL, Neblett Fanfair R, Bernstein KT, Paz-Bailey G. Syphilis trends among men who have sex with men in the United States and Western Europe: A systematic review of Trend Studies published between 2004 and 2015. PLOS ONE. 2016;11(7): 1-19.
European Centre for Disease Prevention and Control. Syphilis. Annual Epidemiological Report for 2018. Stockholm: ECDC; 2020.
Australian Government Department of Health. Third National Sexually Transmissible Infections Strategy 2014–2017. Woden: Australian Government Department of Health; 2014.
Australian Government Department of Health. The Health of Australia’s Males, Sexual Health. Woden: Australian Institute of Health and Welfare; 2014.
Chen G, Cao Y, Yao Y, Li M, Tang W, Li J, et al. Syphilis incidence among men who have sex with men in China: Results from a meta-analysis. Int J STD AIDS. 2016; 28(2):170–8.
Centers for Disease Control and Prevention. 2018 sexually transmitted diseases surveillance: syphilis. Atlanta: CDC; 2019.
Public Health Agency of Canada. Government of Canada. Sexually transmitted infections in men who have sex with men. CCDR 2019; 45(11):1-9.
Wong NS, Chen L, Tucker JD, Zhao P, Goh BT, Poon CM, et al. Distribution of reported syphilis cases in South China: spatiotemporal analysis. Scientific Reports. 2018;8(1):271-82.
Yang S, Wu J, Ding C, Cui Y, Zhou Y, Li Y, et al. Epidemiological features of and changes in incidence of infectious diseases in China in the first decade after the SARS outbreak: an observational trend study. Lancet Infect Dis. 2017;17(7):716–25.
Lukehart SA. Biology of Treponemes. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, et al., editors. Sexually Transmitted Diseases. 4th ed. New York: McGraw Hill Education; 2008.p. 647–59.
Holmes KX, Sparling PF, Stam WE, Piot P, Wasserheit J, Corey L. Clinical Manifestations of Syphilis. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, et al., editors. Sexually Transmitted Disease. 4th ed. New York: McGraw Hill; 2008. p. 661-84.
De Andrade RS, De Freitas EM, Rocha BA, Gusmão EDS, Filho MRM, Júnior HM. Oral findings in secondary syphilis. Med Oral Patol Oral y Cir Bucal. 2018;23(2): p.138–43.
Rapini, R.P. Practical Dermatopathology. Bacterial diseases. Syphilis. 2nd edition. Houston: Elseiver Health Sciences; 2012.
Fernandes A, Ervianti E. Secondary Syphilis in Human Immunodeficiency Virus (HIV)-Infected Men Who Have Sex with Men (MSM): A Case Report. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2020;32(1):75.
Copyright (c) 2024 Berkala Ilmu Kesehatan Kulit dan Kelamin
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.
- The legal formal aspect of journal publication accessibility refers to Creative Commons Atribusi-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)
- The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation
The manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.
