{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T10:33:33Z","timestamp":1756895613895,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,7]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1\u2009week 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.<\/jats:p>","DOI":"10.1136\/bcr-2020-237851","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T12:20:57Z","timestamp":1615983657000},"page":"e237851","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Atypical case of syphilitic hepatitis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1196-2558","authenticated-orcid":false,"given":"Elliott","family":"Goldberg","sequence":"first","affiliation":[{"name":"Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bathai","family":"Edwards","sequence":"additional","affiliation":[{"name":"Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaleigh","family":"Krill","sequence":"additional","affiliation":[{"name":"Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"2025082800483511000_14.3.e237851.1","doi-asserted-by":"crossref","DOI":"10.4103\/0019-5154.127711","article-title":"Syphilitic hepatitis: an uncommon manifestation of a common disease","volume":"59","author":"Baveja","year":"2014","journal-title":"Indian J Dermatol"},{"key":"2025082800483511000_14.3.e237851.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14218\/JCTH.2018.00003","article-title":"A systematic literature review of syphilitic hepatitis in adults","volume":"6","author":"Huang","year":"2018","journal-title":"J Clin Transl Hepatol"},{"key":"2025082800483511000_14.3.e237851.3","first-page":"552","article-title":"Syphilitic hepatitis: a case report and review of the literature","volume":"82","author":"Schlossberg","year":"1987","journal-title":"Am J Gastroenterol"},{"key":"2025082800483511000_14.3.e237851.4","first-page":"60","article-title":"Syphilitic hepatitis","volume":"73","author":"Tiliakos","year":"1980","journal-title":"Am J Gastroenterol"},{"key":"2025082800483511000_14.3.e237851.5","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/1751-2980.12640","article-title":"Hepatitis caused by herpes viruses: a review","volume":"19","author":"Noor","year":"2018","journal-title":"J Dig Dis"},{"key":"2025082800483511000_14.3.e237851.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2007.00207.x"},{"key":"2025082800483511000_14.3.e237851.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/8348172","article-title":"Herpes simplex virus hepatitis in an immunocompetent host resembling hepatic pyogenic abscesses","volume":"2016","author":"Down","year":"2016","journal-title":"Case Reports Hepatol"},{"key":"2025082800483511000_14.3.e237851.8","first-page":"227","article-title":"Severe hepatitis with coagulopathy due to HSV-1 in an immunocompetent man","volume":"70","author":"Wind","year":"2012","journal-title":"Neth J Med"},{"key":"2025082800483511000_14.3.e237851.9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy381"},{"key":"2025082800483511000_14.3.e237851.10","doi-asserted-by":"crossref","unstructured":"Natu A , Iuppa G , Packer CD . Herpes Simplex Virus Hepatitis: A Presentation of Multi-Institutional Cases to Promote Early Diagnosis and Management of the Disease [Internet]. Case Reports in Hepatology. [cited 2019 Nov 23], 2017. Available: https:\/\/www.hindawi.com\/journals\/crihep\/2017\/3180984\/","DOI":"10.1155\/2017\/3180984"},{"key":"2025082800483511000_14.3.e237851.11","doi-asserted-by":"crossref","unstructured":"Then EO , Gayam V , Are VS , et al . Herpes simplex virus hepatitis: a brief review of an Oft-overlooked pathology. Cureus 2019;11 https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6538099\/ doi:10.7759\/cureus.4313","DOI":"10.7759\/cureus.4313"},{"key":"2025082800483511000_14.3.e237851.12","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/24.3.334"},{"key":"2025082800483511000_14.3.e237851.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/23744235.2019.1690676","article-title":"Antinuclear antibodies in infectious diseases","volume":"52","author":"Im","year":"2020","journal-title":"Infect Dis"},{"key":"2025082800483511000_14.3.e237851.14","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-6346(00)00144-3"},{"key":"2025082800483511000_14.3.e237851.15","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-228356","article-title":"False-Positive serologies for acute hepatitis A and autoimmune hepatitis in a patient with acute Epstein-Barr virus infection","volume":"12","author":"Valota","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082800483511000_14.3.e237851.16","unstructured":"Syphilis - 2017 Sexually Transmitted Diseases Surveillance [Internet], 2019. 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