{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:59:44Z","timestamp":1760057984488,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Introduction: Syphilis is a sexually transmitted disease with variable symptoms, often imitating various other disorders. Syphilis progresses through primary, secondary, latent, and tertiary stages, each with distinct clinical manifestations. A sudden rise in serum hepatic enzyme levels and imaging findings that mimic sclerosing cholangitis, both associated with a positive response to targeted antibiotic treatment, may indicate a diagnosis of acute syphilitic hepatitis. Case Presentation: We report a case of early syphilis in the secondary stage, manifesting as sclerosing-cholangitis-like changes shown on ultrasonography, MR, and CT. Narrow-spectrum antibiotic therapy with procaine benzylpenicillin led to a consistent decrease in and normalization of levels of serum bilirubin and other markers of hepatic injury. Repeated sonography and MR cholangiography showed minimal residual changes in the intrahepatic biliary tree. Conclusions: Infection with Treponema pallidum is one of the rare causes of secondary cholangitis. As the incidence of syphilis is rising worldwide, it should be considered as a differential diagnosis, especially for patients with high-risk sexual behavior and for whom there are laboratory findings of cholestatic or mixed cytolytic and cholestatic hepatitis, particularly if associated with exanthema, pharyngitis, and lymphadenopathy.<\/jats:p>","DOI":"10.3390\/idr17020023","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T04:55:08Z","timestamp":1741236908000},"page":"23","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Syphilitic Cholangiopathy Mimicking Primary Sclerosing Cholangitis"],"prefix":"10.3390","volume":"17","author":[{"given":"Adriana","family":"Gregu\u0161ov\u00e1","sequence":"first","affiliation":[{"name":"1st Department of Internal Medicine, Slovak Medical University, Bratislava University Hospital, 83303 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Gergel","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, Slovak Medical University, Bratislava University Hospital, 83303 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2254-436X","authenticated-orcid":false,"given":"Miroslav","family":"\u017digrai","sequence":"additional","affiliation":[{"name":"1st Department of Internal Medicine, Slovak Medical University, Bratislava University Hospital, 83303 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2022). EASL Clinical Practice Guidelines on sclerosing cholangitis. J. Hepatol., 77, 761\u2013806. Erratum in J. Hepatol. 2023, 79, 1339. https:\/\/doi.org\/10.1016\/j.jhep.2023.09.005.","DOI":"10.1016\/j.jhep.2023.09.005"},{"key":"ref_2","unstructured":"Bennett, J.E., Dolin, R., and Blaser, M.J. (2019). Syphilis (Treponema pallidum). Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases, Elsevier. [9th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1159\/000526247","article-title":"Cholestatic Liver Injury in a Patient with Tertiary Syphilis","volume":"16","author":"Mujumdar","year":"2022","journal-title":"Case Rep. 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Dis."}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/17\/2\/23\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:48:06Z","timestamp":1760028486000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/17\/2\/23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,6]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["idr17020023"],"URL":"https:\/\/doi.org\/10.3390\/idr17020023","relation":{},"ISSN":["2036-7449"],"issn-type":[{"type":"electronic","value":"2036-7449"}],"subject":[],"published":{"date-parts":[[2025,3,6]]}}}