{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:42:44Z","timestamp":1791852164192,"version":"4.3.4"},"reference-count":100,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T00:00:00Z","timestamp":1671235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Tertiary syphilis is a large diagnostic challenge. It is rarely the case that it affects the skin, bone tissue and the eyes at the same time. The presented case shows that extensive symptomatology of syphilis poses a challenge in making a proper diagnosis in patients whose history does not suspect STDs. The study aims to present the case of a young woman hospitalized with a suspected autoimmune disease, diagnosed with symptomatic late syphilis with involvement of the skin, bones and eyes.<\/jats:p>","DOI":"10.3390\/ijerph192416992","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T05:55:43Z","timestamp":1671429343000},"page":"16992","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review"],"prefix":"10.3390","volume":"19","author":[{"given":"Lucyna","family":"Jankowska","sequence":"first","affiliation":[{"name":"Department of Dermatology, Heliodor \u015awi\u0119cicki Clinical Hospital, Poznan University of Medical Sciences, 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zygmunt","family":"Adamski","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Heliodor \u015awi\u0119cicki Clinical Hospital, Poznan University of Medical Sciences, 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Pola\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venenerology, Poznan University of Medical Sciences, 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8221-7622","authenticated-orcid":false,"given":"Monika","family":"Bowszyc-Dmochowska","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Heliodor \u015awi\u0119cicki Clinical Hospital, Poznan University of Medical Sciences, 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7646-7430","authenticated-orcid":false,"given":"Katarzyna","family":"Plagens-Rotman","sequence":"additional","affiliation":[{"name":"Center for Pediatric, Adolescent Gynecology and Sexology Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8966-3799","authenticated-orcid":false,"given":"Piotr","family":"Merks","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warszawa, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Czarnecka-Operacz","sequence":"additional","affiliation":[{"name":"Allergic and Occupational Skin Diseases Unit, Department of Dermatology, Medical University of Pozna\u0144, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryszard","family":"\u017baba","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venenerology, Poznan University of Medical Sciences, 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Trovato, E., Tognetti, L., Campoli, M., Cinotti, E., and Rubegni, P. (2021). Syphilis Diagnosis and Treatment: State of the Art. Eur. Med. J.","DOI":"10.33590\/emj\/20-00221"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s40471-018-0138-z","article-title":"An Update on the Global Epidemiology of Syphilis","volume":"5","author":"Kojima","year":"2018","journal-title":"Curr. Epidemiol. Rep."},{"key":"ref_3","unstructured":"Narodowy Instytut Zdrowia Publicznego PZH\u2014Pa\u0144stwowy Instytut Badawczy, Zak\u0142ad Epidemiologii Chor\u00f3b Zaka\u017anych i Nadzoru (2022, August 28). Choroby zaka\u017ane i zatrucia w Polsce w 2020 roku, Available online: http:\/\/wwwold.pzh.gov.pl\/oldpage\/epimeld\/2020\/Ch_2020.pl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1053\/j.spid.2005.04.004","article-title":"The Epidemiology of Sexually Transmitted Infections in Adolescents","volume":"16","author":"Risser","year":"2005","journal-title":"Semin. Pediatr. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.ad.2010.06.014","article-title":"Condom Use and Number of Sexual Partners among Male Syphilis Patients who Report Having Sex with Men","volume":"101","author":"Repiso","year":"2010","journal-title":"Actas Dermosifiliogr."},{"key":"ref_6","first-page":"550","article-title":"Syphilis: Then and now","volume":"XXXVIII","author":"Merks","year":"2021","journal-title":"Adv. Dermatol. Allergol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1001\/jama.1971.03190180033006","article-title":"Therapy for incubating syphilis. Effectiveness of gonorrhea treatment","volume":"218","author":"Schroeter","year":"1971","journal-title":"JAMA"},{"key":"ref_8","unstructured":"Chodynicka, B., Serwin, B.A., Klepacki, J., and Ki\u0142a, W. (2006). Mroczkowski TF Red. Choroby Przenoszone Drog\u0105 P\u0142ciow\u0105, Czelej."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1086\/338829","article-title":"Persons with Early Syphilis Identified through Blood or Plasma Donation Screening in the United States","volume":"185","author":"Gardella","year":"2002","journal-title":"J. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"563","DOI":"10.5114\/dr.2018.79169","article-title":"Syphilis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society. Part 1: Early and late syphilis","volume":"105","author":"Pastuszczak","year":"2018","journal-title":"Dermatol. Rev."},{"key":"ref_11","first-page":"119","article-title":"Syphilis and a pregnant woman: A real danger for the woman and the child","volume":"XXXVI","author":"Przybyslka","year":"2019","journal-title":"Adv. Dermatol. Allergol."},{"key":"ref_12","first-page":"146","article-title":"La syphilis tertiaire cutan\u00e9o-muqueuse","volume":"121","author":"Sekkat","year":"1994","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_13","first-page":"371","article-title":"Two recent cases of tertiary syphilis","volume":"9","author":"Varela","year":"1999","journal-title":"Eur. J. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/S0190-9622(00)90117-8","article-title":"Nodular tertiary syphilis mimicking granuloma annulare","volume":"42","author":"Wu","year":"2000","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_15","first-page":"699","article-title":"Ulc\u00e9ration de jambe \u00e0 type de pyoderma gangrenosum. Manifestation d\u2019une syphilis tertiaire cutan\u00e9e","volume":"114","author":"Vaillant","year":"1987","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_16","first-page":"34","article-title":"Syphilis cutan\u00e9e tertiaire avec sympt\u00f4mes neurologiques","volume":"121","author":"Drobacheff","year":"1994","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/0190-9622(91)70126-M","article-title":"Tertiary syphilis of the face","volume":"24","author":"Chung","year":"1991","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_18","first-page":"750","article-title":"Tubero-Ulcero-Serpiginous Syphilid (A52.7) in Tertiary Syphilis","volume":"115","author":"Schliemann","year":"2018","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/j.lpm.2019.09.047","article-title":"Syphilis tertiaire cutan\u00e9e pseudo-tumorale [Pseudo-tumoral cutaneous tertiary syphilis]","volume":"48","author":"Maouni","year":"2019","journal-title":"Presse Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"749","DOI":"10.5021\/ad.2018.30.6.749","article-title":"Syphilitic Gumma: A Rare Form of Cutaneous Tertiary Syphilis","volume":"30","author":"Moon","year":"2018","journal-title":"Ann. Dermatol."},{"key":"ref_21","first-page":"e48","article-title":"Rapid progression to gummatous tertiary syphilis in a patient with HIV","volume":"60","author":"Puri","year":"2019","journal-title":"Australas. J. Dermatol."},{"key":"ref_22","first-page":"3843174","article-title":"Double Morphology: Tertiary Syphilis and Acquired Immunodeficiency Syndrome\u2014A Rare Association","volume":"2017","author":"Ngwanya","year":"2017","journal-title":"Case Rep. Dermatol. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/ced.13134","article-title":"A pseudotumoral facial mass revealing tertiary syphilis","volume":"42","author":"Benzaquen","year":"2017","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1111\/bjd.14026","article-title":"Tertiary syphilis and Kaposi sarcoma mistaken for systemic sarcoidosis in an HIV-negative patient","volume":"173","author":"Anyasodor","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.1016\/j.urology.2020.08.034","article-title":"Gummatous Syphilis: A Rare Entity Mimicking Carcinoma Penis","volume":"146","author":"Mathew","year":"2020","journal-title":"Urology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1177\/0956462416665973","article-title":"First report of tertiary syphilis presenting as lipoatrophic panniculitis in an immunocompetent patient","volume":"28","author":"Drago","year":"2017","journal-title":"Int. J. STD AIDS"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"82","DOI":"10.11604\/pamj.2013.15.82.3011","article-title":"Granulome centro-facial r\u00e9v\u00e9lant une syphilis tertiaire [Centro-facial granuloma revealing a tertiary syphilis]","volume":"15","author":"Chakir","year":"2013","journal-title":"Pan Afr. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e350","DOI":"10.1111\/jdv.17863","article-title":"Cutaneous tertiary syphilitic gumma on the scalp","volume":"36","author":"Terada","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1055\/s-0034-1387213","article-title":"Hautmanifestation bei Sp\u00e4tsyphilis [Cutaneous manifestation of late-type syphilis]","volume":"139","author":"Schummer","year":"2014","journal-title":"Dtsch. Med. Wochenschr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1089\/aid.2015.0321","article-title":"Rapid Progression and Overlapping of Skin Eruptions in a Patient with Secondary and Tertiary Syphilis Coinfected with HIV","volume":"32","author":"Szetela","year":"2016","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/cup.12770","article-title":"Syphilitic gumma arising in association with foreign material","volume":"43","author":"Boyd","year":"2016","journal-title":"J. Cutan. Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e185","DOI":"10.1111\/ijd.12183","article-title":"An annular patch of the scalp reveals tertiary syphilis","volume":"53","author":"Bekkali","year":"2014","journal-title":"Int. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.bjid.2016.01.007","article-title":"Tertiary syphilis: Tubero-serpiginous and tubero-ulcerous syphilids","volume":"20","author":"Jorge","year":"2016","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e151","DOI":"10.1111\/jdv.16882","article-title":"Concurrent benign tertiary syphilis and asymptomatic neurosyphilis in an immunocompetent patient","volume":"35","author":"Cozzani","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_35","first-page":"829","article-title":"Gummatous syphilis: A case report","volume":"17","author":"Alikhani","year":"2019","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2324709618820355","DOI":"10.1177\/2324709618820355","article-title":"An Unusual Case of Tertiary Syphilis Behaving Like Tongue Squamous Cell Carcinoma","volume":"6","author":"Solis","year":"2018","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/ddg.13087","article-title":"Crusted papulopustular lesions, plaques and ulcers","volume":"15","author":"Pfaff","year":"2017","journal-title":"J. Dtsch. Dermatol. Ges"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0190-9622(86)70173-4","article-title":"Granulomatous tertiary syphilis","volume":"15","author":"Tanabe","year":"1986","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5070\/D37C04J4T1","article-title":"Benign nodular tertiary syphilis: A rare presenting manifestation of HIV infection","volume":"17","author":"Revathi","year":"2011","journal-title":"Dermatol. Online J."},{"key":"ref_40","first-page":"431","article-title":"Late syphilis mimicking a pseudolymphoma of the skin","volume":"16","author":"Erfurt","year":"2006","journal-title":"Eur. J. Dermatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e9098","DOI":"10.1097\/MD.0000000000009098","article-title":"Syphilis of the lumbar spine: A case report and review of the literature","volume":"96","author":"Yin","year":"2017","journal-title":"Medicine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1055\/s-0032-1329887","article-title":"Tertiary syphilis in the cervical spine: A case report and review of the literature","volume":"3","author":"Salem","year":"2012","journal-title":"Glob. Spine J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/RLU.0000000000002450","article-title":"Gummatous Syphilis Mimicking Malignant Bone Tumor on FDG PET\/CT","volume":"44","author":"Wang","year":"2019","journal-title":"Clin. Nucl. Med."},{"key":"ref_44","first-page":"5533686","article-title":"Spinal Syphilitic Gumma: A Rare Presentation of an Old Disease","volume":"2021","author":"Worku","year":"2021","journal-title":"Case Rep. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"bcr2014204259","DOI":"10.1136\/bcr-2014-204259","article-title":"Prosthetic rehabilitation of palatal perforation in a patient with \u2018syphilis: The great imitator\u2019","volume":"2014","author":"Murthy","year":"2014","journal-title":"BMJ Case Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1056\/NEJMicm1313142","article-title":"Images in clinical medicine: Syphilitic gumma","volume":"371","author":"Cherniak","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1111\/dth.12020","article-title":"A case of tertiary neurosyphilis presenting with moth-eaten bone lesions","volume":"26","author":"Xu","year":"2013","journal-title":"Dermatol. Ther."},{"key":"ref_48","first-page":"e17344","article-title":"The Great Impostor Did It Again: Syphilitic Arthritis","volume":"13","author":"Ao","year":"2021","journal-title":"Cureus"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.radcr.2021.01.056","article-title":"Cerebral syphilitic gumma presenting with intracranial gumma and pathologic vertebrae fractures","volume":"16","author":"Thibodeau","year":"2021","journal-title":"Radiol. Case Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4103\/0253-7184.156745","article-title":"Squamous cell carcinoma on a syphilitic gumma: A unique presentation","volume":"36","author":"Rahima","year":"2015","journal-title":"Indian J. Sex. Transm. Dis. AIDS"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Bai, Y., Niu, F., Liu, L., Sha, H., Wang, Y., and Zhao, S. (2017). Tertiary syphilis in the lumbar spine: A case report. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2620-5"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.ihj.2014.10.408","article-title":"Cardiovascular syphilis with coronary stenosis and aneurysm","volume":"66","author":"Tewari","year":"2014","journal-title":"Indian Heart J."},{"key":"ref_53","first-page":"151","article-title":"Aortic aneurysm in a patient with syphilis-related spinal pain and paraplegia","volume":"3","author":"Oliveira","year":"2017","journal-title":"Reumatologia"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1055\/s-0040-1714057","article-title":"Repair of a Syphilitic Aneurysm of the Noncoronary Sinus","volume":"8","author":"Kinsey","year":"2020","journal-title":"Aorta"},{"key":"ref_55","first-page":"e13647","article-title":"Syphilitic Aortic Aneurysm: A Rare Entity in the Era of Antibiotics","volume":"13","author":"Chaudhary","year":"2021","journal-title":"Cureus"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1111\/echo.15055","article-title":"A dissecting aneurysm of the sinus of Valsalva involving the inter-ventricsular septum in a patient with syphilis and a quadricuspid aortic valve","volume":"38","author":"Li","year":"2021","journal-title":"Echocardiography"},{"key":"ref_57","first-page":"166","article-title":"Syphilitic Aortitis Diagnosis in Clinical Setting","volume":"24","author":"Fernandes","year":"2017","journal-title":"Rev. Port Cir. Cardiotorac. Vasc."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"255","DOI":"10.2147\/VHRM.S289455","article-title":"Impending Aortic Rupture in a Patient with Syphilitic Aortitis","volume":"17","author":"Cocora","year":"2021","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4103\/0253-7184.132431","article-title":"A rare case of tertiary syphilis complicated with aortic aneurysm in this era of early use of highly effective antibiotics","volume":"35","author":"Vasudevan","year":"2014","journal-title":"Indian J. Sex. Transm. Dis. AIDS"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e12531","DOI":"10.1111\/anec.12531","article-title":"Acute coronary syndrome of very unusual etiology","volume":"23","author":"Koivula","year":"2018","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.medici.2017.06.001","article-title":"Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction","volume":"53","author":"Jankauskas","year":"2017","journal-title":"Medicina"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"bcr2013200910","DOI":"10.1136\/bcr-2013-200910","article-title":"Multiple embolic stroke due to aortic arch floating thrombus in latent tertiary syphilis","volume":"2013","author":"Ripellino","year":"2013","journal-title":"BMJ Case Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1007\/s11748-020-01523-y","article-title":"Syphilitic aortitis: Chronic left coronary ostial occlusion and aortic regurgitation with aortitis","volume":"69","author":"Nomura","year":"2021","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1161\/CIRCIMAGING.113.001136","article-title":"An unusual case of epigastric and back pain: Expanding descending thoracic aneurysm resulting from tertiary syphilis diagnosed with positron emission tomography","volume":"6","author":"Silvestri","year":"2013","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jns.2012.07.058","article-title":"Syphilitic aortic aneurysm with spastic paraparesis: A novel presentation and review of the literature","volume":"323","author":"Gugssa","year":"2012","journal-title":"J. Neurol. Sci."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Spaltenstein, M., Humbert, F., Vu, D.-L., U\u00e7kay, I., and John, G. (2017). A case report of CT-diagnosed renal infarct secondary to syphilitic aortitis. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2624-1"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.clineuro.2018.08.005","article-title":"A case of sciatica revealing a giant syphilitic aneurysm","volume":"174","author":"Iodice","year":"2018","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_68","first-page":"e9397","article-title":"A Rare Case of an Abdominal Aortic Thrombus Secondary to Syphilitic Aortitis","volume":"12","author":"Jadav","year":"2020","journal-title":"Cureus"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1177\/15385744211042492","article-title":"Syphilitic Popliteal Pseudoaneurysm Complicated by Acute Lower-Limb Ischemia","volume":"56","author":"Arasu","year":"2022","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"E401","DOI":"10.1532\/hsf.2561","article-title":"Giant Aortic Syphilitic Aneurysm of the Ascending Aorta with Erosion in the Chest Wall: Case Report","volume":"22","author":"Stiru","year":"2019","journal-title":"Heart Surg. Forum"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s12024-021-00419-4","article-title":"Sudden death due to rupture of an aortic syphilitic aneurysm","volume":"18","author":"Kislov","year":"2022","journal-title":"Forensic Sci. Med. Pathol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e20210160","DOI":"10.1590\/1677-5449.210160","article-title":"Contained rupture of an aortic arch aneurysm in a patient with syphilitic aortitis. A case report","volume":"20","author":"Bilman","year":"2022","journal-title":"J. Vasc. Bras."},{"key":"ref_73","first-page":"642","article-title":"Syphilitic pancreatitis: A rare mimicker of our time","volume":"110","author":"Mekonnen","year":"2020","journal-title":"S. Afr. Med. J."},{"key":"ref_74","unstructured":"Denisova, T.L., Tiul\u2019tiaeva, L.A., Lipatova, T.E., Bakulev, A.L., Alipova, L.N., Apanasevich, A.V., Bezrodnaia, L.A., and Borisova, E.A. (2013). Tertiary syphilis of the pancreas and liver in 82-year-old patient: Case study. Eksp. Klin. Gastroenterol., 41\u201343. (In Russia)."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.1016\/j.cgh.2014.04.022","article-title":"Syphilitic gummas mistaken for liver metastases","volume":"12","author":"Gaslightwala","year":"2014","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"rjac093","DOI":"10.1093\/jscr\/rjac093","article-title":"Tertiary syphilis mimicking metastatic rectal cancer","volume":"2022","author":"Smith","year":"2022","journal-title":"J. Surg. Case Rep."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Tee, S.A., Gan, E.H., Kanaan, M.Z., Price, D.A., Hoare, T., and Pearce, S. (2018). An unusual cause of adrenal insufficiency and bilateral adrenal masses. Endocrinol. Diabetes Metab. Case Rep., 2018.","DOI":"10.1530\/EDM-18-0030"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e025995","DOI":"10.1136\/bmjopen-2018-025995","article-title":"Retrospective review of tertiary and neurosyphilis cases in Alberta, 1973\u20132017","volume":"9","author":"Landry","year":"2019","journal-title":"BMJ Open"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e01521","DOI":"10.1016\/j.idcr.2022.e01521","article-title":"A peculiar case of syphilis infection: The great imitator is on the rise","volume":"28","author":"Eijmael","year":"2022","journal-title":"IDCases"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1750-1172-7-20","article-title":"Beh\u00e7et\u2019s disease","volume":"7","author":"Saadoun","year":"2012","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"International Team for the Revision of the International Criteria for Beh\u00e7et\u2019s Disease (ITR-ICBD), Davatchi, F., Assaad-Khalil, S., Calamia, K., Crook, J., Sadeghi-Abdollahi, B., Schirmer, M., Tzellos, T., Zouboulis, C., and Akhlagi, M. (2014). The International Criteria for Beh\u00e7et\u2019s Disease (ICBD): A collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J. Eur. Acad. Dermatol. Venereol., 28, 338\u2013347.","DOI":"10.1111\/jdv.12107"},{"key":"ref_82","first-page":"3","article-title":"The Oslo study of untreated syphilis: An epidemiologic investigation of the natural course of the syphilitic infection based upon a study of the Boeck-Bruusgard material","volume":"35","author":"Gjestland","year":"1955","journal-title":"Acta Derm. Venereol. Suppl. (Stockh.)"},{"key":"ref_83","unstructured":"Jab\u0142o\u0144ska, S. (1967). Choroby Weneryczne. PZWL, 95\u2013132."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Parker, J., Liszewski, W., Merten, A.H., Gaddis, K., Pragman, A., and Goldfarb, N. (2020). A perplexing case of superficial granulomatous pyoderma with sporotrichoid-like distribution. Dermatol. Online J., 26.","DOI":"10.5070\/D3266049322"},{"key":"ref_85","first-page":"26","article-title":"Ki\u0142a o\u015brodkowego uk\u0142adu nerwowego\u2014Trudno\u015bci diagnostyczne","volume":"9","author":"Zajkowska","year":"2014","journal-title":"Neurologia po Dyplomie"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1071\/SH14153","article-title":"Increasing trends of syphilis among men who have sex with men in high income countries","volume":"12","author":"Read","year":"2015","journal-title":"Sex. Health"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1258\/ijsa.2008.008510","article-title":"IUSTI: 2008 European Guidelines on the Management of Syphilis","volume":"20","author":"French","year":"2009","journal-title":"Int. J. STD AIDS"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"487","DOI":"10.4103\/0028-3886.284383","article-title":"General paresis of insane: A forgotten entity","volume":"68","author":"Sharma","year":"2020","journal-title":"Neurol. India"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"395","DOI":"10.3201\/eid2402.171444","article-title":"Cerebral Syphilitic Gumma in Immunocompetent Man, Japan","volume":"24","author":"Kodama","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.3201\/eid2210.160600","article-title":"Cerebral Syphilitic Gumma within 5 Months of Syphilis in HIV-Infected Patient","volume":"22","author":"Tsuboi","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/OLQ.0b013e31827df2c6","article-title":"A patient with multifocal tabetic arthropathy: A case report and review of literature","volume":"40","author":"Schotanus","year":"2013","journal-title":"Sex. Transm. Dis."},{"key":"ref_92","first-page":"e14011","article-title":"Tabes Dorsalis in a Patient Presenting with Right Lower Extremity Paresthesia and Cervical Spine Pain","volume":"13","author":"Creech","year":"2021","journal-title":"Cureus"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s00701-016-3015-x","article-title":"Occipital lobe gumma: A case report and review of the literature","volume":"159","author":"Faropoulos","year":"2017","journal-title":"Acta Neurochir."},{"key":"ref_94","first-page":"e6337","article-title":"Neurosyphilis Presenting as Intermittent Explosive Disorder and Acute Psychosis","volume":"11","author":"Saini","year":"2019","journal-title":"Cureus"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/s41394-020-0303-8","article-title":"Neurosyphilis revealed by compressive cervical spine syphilitic gumma: A case report","volume":"6","author":"Mejdoubi","year":"2020","journal-title":"Spinal Cord Ser. Cases"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.3171\/2019.5.FOCUS1953","article-title":"Cerebral syphilitic gumma masquerading as cerebral metastatic tumors: Case report","volume":"47","author":"Weng","year":"2019","journal-title":"Neurosurg. Focus"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.revmed.2013.05.011","article-title":"Une cause rare de fracture pathologique [An unusual cause of bone fracture]","volume":"34","author":"Daumas","year":"2013","journal-title":"Rev. Med. Interne."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1016\/j.radcr.2022.02.044","article-title":"Neurosyphilis presenting with focal middle cerebral artery stenosis and acute ischemic stroke: A case report","volume":"17","author":"Currens","year":"2022","journal-title":"Radiol. Case Rep."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/OLQ.0000000000000701","article-title":"Cerebral Syphilitic Gumma Can Arise within Months of Reinfection: A Case of Histologically Proven Treponema pallidum Strain Type 14b\/f Infection With Human Immunodeficiency Virus Positivity","volume":"45","author":"Koizumi","year":"2018","journal-title":"Sex. Transm. Dis."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"29","DOI":"10.11604\/pamj.2013.16.29.3360","article-title":"Gomme du visage revelant une syphilis congenitale tardive [Gumma of the face revealing a late congenital syphilis]","volume":"16","author":"Taghy","year":"2013","journal-title":"Pan Afr. Med. J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/24\/16992\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:43:25Z","timestamp":1760147005000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/24\/16992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,17]]},"references-count":100,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["ijerph192416992"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192416992","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,17]]}}}