{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:55:48Z","timestamp":1740164148562,"version":"3.37.3"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Infectious Diseases"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Syphilis is a sexually transmitted infection that remains fairly commonplace. The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV), syphilis is now on a resurgence with sometimes curious presentations. We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis. Skin lesions were reminiscent of \u201cmalignant\u201d syphilis. CD4 count was 57\u2009cells\/<jats:italic>\u03bc<\/jats:italic>L. RPR was elevated with 1\u2009:\u200964 titer and positive confirmatory TP-PA. Radiography of the limbs revealed polyostotic cortical irregularities corroborated on bone scintigraphy. The patient had an unknown penicillin allergy and was unwilling to conduct a trial of penicillin-based therapy. He was subsequently treated with doxycycline 100\u2009mg twice daily for 6 weeks and commenced antiretroviral therapy, noting dramatic improvement in both the skin lesions and joint pains. Unfortunately, he defaulted on follow-up, precluding serial RPR and bone imaging. Penicillin allergies have proven to be quite a conundrum in such patients, without much recourse for alternative therapy. Doxycycline with\/without azithromycin is other options worth considering.<\/jats:p>","DOI":"10.1155\/2016\/4983504","type":"journal-article","created":{"date-parts":[[2016,5,29]],"date-time":"2016-05-29T17:01:00Z","timestamp":1464541260000},"page":"1-6","source":"Crossref","is-referenced-by-count":2,"title":["Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature"],"prefix":"10.1155","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0101-2938","authenticated-orcid":true,"given":"Robert","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Florida-Jacksonville, 655 W 8th Street, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9675-2896","authenticated-orcid":true,"given":"Julio","family":"Perez-Downes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Florida-Jacksonville, 655 W 8th Street, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3584-9453","authenticated-orcid":true,"given":"Firas","family":"Baidoun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Florida-Jacksonville, 655 W 8th Street, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bashar","family":"Al Turk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Florida-Jacksonville, 655 W 8th Street, Jacksonville, FL 32209, 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