{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T09:03:01Z","timestamp":1794214981366,"version":"4.8.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>Untreated syphilis may lead to severe complications. This infection has recently re-emerged in developed countries with a high number of cases coinfected with human immunodeficiency virus. In these patients, the skin lesions of secondary syphilis can be very atypical.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We report the case of a 38-year-old Bulgarian homosexual man who was coinfected with human immunodeficiency virus and syphilis. His skin contained multiple extensive necrotic lesions with abundant purulent secretion that covered his face, lips, scalp, and torso. Initial clinical diagnoses included varicella pustulosa and staphylococcal dermatitis. Human immunodeficiency virus infection in our patient had been established 2 years earlier in prophylactic studies, but had not been treated. Due to lack of penicillin, he was successfully treated with ceftriaxone, and the skin lesions underwent complete reversal. He also began antiretroviral therapy, which resulted in a significant effect on his immune status. Three months after the onset of antiretroviral therapy, he also achieved optimal viral suppression.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This case emphasizes the importance of considering cutaneous secondary syphilis in the differential diagnosis of any inflammatory cutaneous disorder in individuals infected with human immunodeficiency virus.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13256-019-2291-5","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T01:02:28Z","timestamp":1575853348000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Atypical secondary syphilis presentation in a patient with human immunodeficiency virus infection: a case report"],"prefix":"10.1186","volume":"13","author":[{"given":"Nina","family":"Yancheva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Petrova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana","family":"Tchervenyakova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"2291_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.clindermatol.2005.01.015","volume":"23","author":"LA Dourmishev","year":"2005","unstructured":"Dourmishev LA, Assen L. Syphilis: uncommon presentations in adults. Clin Dermatol. 2005;23:555\u201364.","journal-title":"Clin Dermatol"},{"key":"2291_CR2","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1007\/s15010-015-0783-9","volume":"43","author":"A Zink","year":"2015","unstructured":"Zink A, Kaliebe K, Spinner CD. Alopecia syphilitica diffusa. Infection. 2015;43:783\u20134.","journal-title":"Infection"},{"key":"2291_CR3","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1097\/01.olq.0000149848.03733.c1","volume":"32","author":"I Simms","year":"2005","unstructured":"Simms I, Fenton KA, Ashton M, Turner KME, Crawley-Boevey EE, Gorton R, et al. The re-emergence of syphilis in the United Kingdom: The new epidemic phases. 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Vesiculobullous syphilis: a case involving an unusual cutaneous manifestation of secondary syphilis. J Foot Ankle Surg. 2011;50:96\u2013101.","journal-title":"J Foot Ankle Surg"},{"issue":"1","key":"2291_CR7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.4103\/2229-5178.79864","volume":"2","author":"J Rajan","year":"2011","unstructured":"Rajan J, Prasad PVC, Chokalingam K, Kaviarasan PK. Malignant syphilis with human immunodeficiency virus infection. Indian Dermatol Online J. 2011;2(1):19\u201322.","journal-title":"Indian Dermatol Online J"},{"issue":"2","key":"2291_CR8","first-page":"85","volume":"10","author":"J Pialoux","year":"2008","unstructured":"Pialoux J, Vimont S, Moulignier A, Buteux M, Abraham B, Bonnard P. Effect of HIV Infection on the Course of Syphilis. 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Meta-analysis of ceftriaxone compared with penicillin for the treatment of syphilis. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"360"}}