{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T12:01:32Z","timestamp":1774958492687,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,8]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>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\u2009weeks. 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.<\/jats:p>","DOI":"10.1136\/bcr-2021-243195","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T12:21:56Z","timestamp":1624537316000},"page":"e243195","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Localised cervical lymphadenopathy: a rare presenting sign of syphilis"],"prefix":"10.1136","volume":"14","author":[{"given":"Elisa Hendrika","family":"Adriaansens","sequence":"first","affiliation":[{"name":"Internal Medicine, Amphia Ziekenhuis Locatie Molengracht, Breda, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5641-3371","authenticated-orcid":false,"given":"Marieke E C","family":"van Winden","sequence":"additional","affiliation":[{"name":"Dermatology, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"van Wijngaarden","sequence":"additional","affiliation":[{"name":"Internal Medicine, Amphia Ziekenhuis Locatie Molengracht, Breda, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"2025082709012859000_14.6.e243195.1","unstructured":"Centers for Disease Control and Prevention . Sexually Transmitted Disease Surveillance 2017 [Internet], 2018: 23\u201330. https:\/\/www.cdc.gov\/std\/stats17\/2017-STD-Surveillance-Report_CDC-clearance-9.10.18.pdf"},{"key":"2025082709012859000_14.6.e243195.2","unstructured":"European Centre for Disease Prevention and Control . Syphilis annual epidemiological report for 2017. 7, 2019."},{"key":"2025082709012859000_14.6.e243195.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.11.1510"},{"key":"2025082709012859000_14.6.e243195.4","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.2.187"},{"key":"2025082709012859000_14.6.e243195.5","unstructured":"MMBZ: Syfilis (lues) [Internet]. Mmbz.nl. 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