{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:34:11Z","timestamp":1790480051671,"version":"4.1.0"},"reference-count":61,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The rate of reported syphilis cases is increasing worldwide, particularly among men who have sex with men. In this scenario, malignant syphilis is a rare, severe form of secondary syphilis, typically observed in immunocompromised individuals and characterized by rupioid skin lesions, together with systemic symptoms that could lead to potentially life-threatening complications. We report the complex case of a 42-year-old man, previously diagnosed with HIV infection, presenting with a five-day history of fever and multiple lymphadenopathies. His immunovirological status was well controlled, and he was fully adherent to antiretroviral therapy. His clinical presentation was severe and ambiguous, with neurological involvement being progressively excluded. The diagnosis was confirmed by serological tests, while histopathological examination of an excised lymph node revealed disrupted architecture with multiple granulomas. Differential diagnosis, including lymphoma and other potential etiologies, was performed. After completion of antibiotic therapy, clinical symptoms completely resolved. No Jarisch\u2013Herxheimer reaction occurred. We also provide an updated review of the current literature, with a focus on HIV coinfection, which is frequently associated with the development of malignant syphilis, and discuss the need for enhanced interventions to prevent sexually transmitted infections, as well as the importance of judicious use of doxycycline post-exposure prophylaxis.<\/jats:p>","DOI":"10.3390\/microorganisms13050968","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:04:50Z","timestamp":1745467490000},"page":"968","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Malignant Syphilis Mimicking Lymphoma in HIV: A Challenging Case and a Review of Literature Focusing on the Role of HIV and Syphilis Coinfection"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9754-9435","authenticated-orcid":false,"given":"Chiara","family":"Maci","sequence":"first","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-7193","authenticated-orcid":false,"given":"Diana","family":"Canetti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Tassan Din","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3601-7686","authenticated-orcid":false,"given":"Elena","family":"Bruzzesi","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francesca","family":"Lucente","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Badalucco Ciotta","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8163-3130","authenticated-orcid":false,"given":"Caterina","family":"Candela","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0055-325X","authenticated-orcid":false,"given":"Maurilio","family":"Ponzoni","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"},{"name":"Pathology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2673-2731","authenticated-orcid":false,"given":"Silvia","family":"Nozza","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"ref_1","unstructured":"(2025, February 10). STI Cases on the Rise Across Europe. Available online: https:\/\/www.ecdc.europa.eu\/en\/news-events\/sti-cases-rise-across-europe."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"bcr2013201554","DOI":"10.1136\/bcr-2013-201554","article-title":"The CARE guidelines: Consensus-based clinical case reporting guideline development","volume":"2013","author":"Gagnier","year":"2013","journal-title":"BMJ Case Rep."},{"key":"ref_3","first-page":"3\u2013LVI","article-title":"The Oslo study of untreated syphilis: An epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material","volume":"35","author":"Gjestland","year":"1955","journal-title":"Acta Derm.-Venereol. Suppl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually Transmitted Infections Treatment Guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm. Rep."},{"key":"ref_5","unstructured":"Bennett, J.E., Dolin, R., and Blaser, M.J. (2019). Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases, Elsevier. [9th ed.]. 2-Volume Set."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1111\/ijd.12518","article-title":"The great imitator revisited: The spectrum of atypical cutaneous manifestations of secondary syphilis","volume":"53","author":"Balagula","year":"2014","journal-title":"Int. J. Dermatol."},{"key":"ref_7","unstructured":"(2025, February 10). Syphilis-Annual Epidemiological Report for 2023. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/syphilis-annual-epidemiological-report-2023#:~:text=In%202023%2C%2041%20051%20confirmed,100%25%20increase%20compared%20to%202014."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/ijd.16444","article-title":"Malignant syphilis: A new and revised definition","volume":"62","author":"Karanfilian","year":"2023","journal-title":"Int. J. Dermatol."},{"key":"ref_9","first-page":"232","article-title":"Syphilis Maligna: A Presentation to Bear in Mind","volume":"110","author":"Manzardo","year":"2019","journal-title":"Actas Dermosifiliogr. (Engl. Ed)."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1346-8138.2001.tb00107.x","article-title":"Mucocutaneous manifestations of secondary syphilis in north Indian patients: A changing scenario?","volume":"28","author":"Kumar","year":"2001","journal-title":"J. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Anand, P., Quilter, L., Learner, E., Barbee, L., and Jackson, D. (2024). Trends in syphilis case rates among women of reproductive age\u2014United States, 2013\u20132022. Sex. Transm. Dis., Online ahead of print.","DOI":"10.1097\/OLQ.0000000000002127"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"US Preventive Services Task Force (2022). Screening for Syphilis Infection in Nonpregnant Adolescents and Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA, 328, 1243\u20131249.","DOI":"10.1001\/jama.2022.15322"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Zhou, P., Ye, M., Tucker, J.D., Zhang, L., and Radolf, J.D. (2023). Editorial: Syphilis infection: Clinical, epidemiology, basic science, and behavioral research. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1182069"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.ad.2021.02.011","article-title":"Malignant Syphilis: A Systematic Review of the Case Reports Published in 2014\u20132018. S\u00edfilis maligna: Revisi\u00f3n sistem\u00e1tica de los casos publicados entre los a\u00f1os 2014\u20132018","volume":"112","author":"Wibisono","year":"2021","journal-title":"Actas Dermo-Sifiliogr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hussen, S., and Tadesse, B.T. (2019). Prevalence of Syphilis among Pregnant Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. BioMed Res. Int., 2019.","DOI":"10.1155\/2019\/4562385"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sunguya, B., Mboya, E.A., Mizinduko, M., Balandya, B., Sabasaba, A., Amani, D.E., Kamori, D., Ruhago, G., Mkumbwa, R., and Faustine, P. (2023). Epidemiology of syphilis infections among pregnant women in Tanzania: Analysis of the 2020 national representative sentinel surveillance. PLoS ONE, 18.","DOI":"10.1101\/2023.04.16.23288656"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"04004","DOI":"10.7189\/jogh.14.04004","article-title":"Syphilis epidemic among men who have sex with men: A global systematic review and meta-analysis of prevalence, incidence, and associated factors","volume":"14","author":"Zheng","year":"2024","journal-title":"J. Glob Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1080\/09540121.2021.1967854","article-title":"HIV and syphilis prevalence among transgender women and men who have sex with men, Silom Community Clinic, Bangkok, Thailand, 2017\u20132019","volume":"34","author":"Pattanasin","year":"2022","journal-title":"AIDS Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s10508-022-02460-y","article-title":"The Interactions Between Vulnerabilities for HIV and Syphilis among Cisgender and Transgender People Who Use Drugs","volume":"52","author":"Ribeiro","year":"2023","journal-title":"Arch. Sex. Behav."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s10461-016-1485-8","article-title":"HIV and Syphilis Prevalence Among Transgender Women in Ho Chi Minh City, Vietnam","volume":"20","author":"Colby","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e240003","DOI":"10.1590\/1980-549720240003.supl.1","article-title":"Prevalence of syphilis in transgender women and travestis in Brazil: Results from a national cross-sectional study","volume":"27","author":"Rocha","year":"2024","journal-title":"Rev. Bras. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/S0140-6736(22)02348-0","article-title":"Syphilis","volume":"402","author":"Peeling","year":"2023","journal-title":"Lancet"},{"key":"ref_23","first-page":"11","article-title":"Malignant syphilis","volume":"9","author":"Neisser","year":"1897","journal-title":"Br. J. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ciccarese, G., Facciorusso, A., Mastrolonardo, M., Herzum, A., Parodi, A., and Drago, F. (2024). Atypical Manifestations of Syphilis: A 10-Year Retrospective Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13061603"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1089\/apc.1998.12.921","article-title":"Malignant syphilis: A review","volume":"12","author":"Kumar","year":"1998","journal-title":"AIDS Patient Care STDs"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/0956462419826710","article-title":"Neurosyphilis is more common in malignant syphilis: A case series and review of the literature","volume":"30","author":"Zhu","year":"2019","journal-title":"Int. J. STD AIDS"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e157","DOI":"10.1111\/j.1755-5949.2010.00183.x","article-title":"REVIEW: Neurosyphilis: A historical perspective and review","volume":"16","author":"Ghanem","year":"2010","journal-title":"CNS Neurosci. Ther."},{"key":"ref_28","first-page":"833","article-title":"Necrotizing and vegetating syphilides\u2014Rare manifestations of secondary syphilis","volume":"10","author":"Lang","year":"2008","journal-title":"J. Der Dtsch. Dermatol. Ges."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1288\/00005537-197511000-00012","article-title":"Hearing loss of acquired syphilis: Diagnosis confirmed by incudectomy","volume":"85","author":"Nadol","year":"1975","journal-title":"Laryngoscope"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.clindermatol.2005.01.015","article-title":"Syphilis: Uncommon presentations in adults","volume":"23","author":"Dourmishev","year":"2005","journal-title":"Clin. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.3904\/kjim.2013.28.2.231","article-title":"A case of secondary syphilis presenting as multiple pulmonary nodules","volume":"28","author":"Kim","year":"2013","journal-title":"Korean J. Intern. Med."},{"key":"ref_32","first-page":"e50105","article-title":"Syphilis-Related Nephropathy: A Rare Manifestation of a Reemerging Disease","volume":"15","author":"Mahmood","year":"2023","journal-title":"Cureus"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7301a1","article-title":"CDC Laboratory Recommendations for Syphilis Testing, United States, 2024","volume":"73","author":"Papp","year":"2024","journal-title":"MMWR Recomm. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1001\/archderm.1969.01610190076014","article-title":"Lues maligna. Presentation of a cas and a review of the literature","volume":"99","author":"Fisher","year":"1969","journal-title":"Arch. Dermatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"499","DOI":"10.3390\/idr16030038","article-title":"An Exuberant Case of Ulceronodular-Rupioid (Malignant) Syphilis in an HIV Patient: A Proposal for New Diagnostic Criteria","volume":"16","author":"Jimenez","year":"2024","journal-title":"Infect. Dis. Rep."},{"key":"ref_36","first-page":"176","article-title":"Active syphilis in HIV infection: A multicentre retrospective survey. The German AIDS Study Group (GASG)","volume":"72","author":"Imhof","year":"1996","journal-title":"Genitourin. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1590\/abd1806-4841.20164491","article-title":"Early malignant syphilis","volume":"91","author":"Ortigosa","year":"2016","journal-title":"An. Bras. Dermatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jiac.2017.03.003","article-title":"Secondary syphilis mimicking malignancy: A case report and review of literature","volume":"23","author":"Cerchione","year":"2017","journal-title":"J. Infect. Chemother. Off. J. Jpn. Soc. Chemother."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1111\/j.1365-4362.1991.tb03506.x","article-title":"Malignant syphilis or syphilis simulating malignancy","volume":"30","author":"Sharma","year":"1991","journal-title":"Int. J. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"238","DOI":"10.12659\/AJCR.907127","article-title":"Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma","volume":"19","author":"Komeno","year":"2018","journal-title":"Am. J. Case reports"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Dimnik, J., Benko, M., Hosta, V., Murnik Rauh, A., Pagon, A., \u0160pik, V.C., Battelino, S., and Vozel, D. (2022). Malignant Syphilis in a Female Patient: A Case Report and Mini-Review. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7030047"},{"key":"ref_42","first-page":"e640","article-title":"A clinical and diagnostic dilemma: Syphilis mimicking monkeypox","volume":"38","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol. JEADV"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"(2016). The Relationship Between Herpes Zoster, Syphilis and Chickenpox. JAMA, 316, 2555.","DOI":"10.1001\/jama.2015.17114"},{"key":"ref_44","unstructured":"(2025, February 10). Sexually Transmitted Infections Treatment Guidelines, Available online: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/p-and-s-syphilis.htm."},{"key":"ref_45","first-page":"S382","article-title":"Malignant Syphilis in a Young Patient With Juvenile Idiopathic Arthritis Under Biological Therapy","volume":"27","author":"Benevides","year":"2021","journal-title":"J. Clin. Rheumatol. Pract. Rep. Rheum. Musculoskelet. Dis."},{"key":"ref_46","first-page":"632","article-title":"Malignant syphilis in HIV negative patient treated with ibrutinib","volume":"36","year":"2023","journal-title":"Rev. Esp. Quimioter. Publ. Of. Soc. Esp. Quimioterapia"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1093\/cid\/ciab944","article-title":"Syphilis Testing and Diagnosis Among People With Human Immunodeficiency Virus (HIV) Engaged in Care at 4 US Clinical Sites, 2014\u20132018","volume":"75","author":"Menza","year":"2022","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/OLQ.0000000000000986","article-title":"Increasing Syphilis Detection Among Patients Assigned Male at Birth Screened at a Boston Community Health Center Specializing in Sexual and Gender Minority Health, 2005\u20132015","volume":"46","author":"Hazra","year":"2019","journal-title":"Sex. Transm. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/S1473-3099(04)01061-8","article-title":"Syphilis and HIV: A dangerous combination","volume":"4","author":"Lynn","year":"2004","journal-title":"Lancet Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s12981-022-00493-w","article-title":"Effects of syphilis infection among HIV-1-positive individuals on suppressive antiretroviral therapy","volume":"19","author":"Chan","year":"2022","journal-title":"AIDS Res. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1097\/00002030-200410210-00012","article-title":"Syphilis increases HIV viral load and decreases CD4 cell counts in HIV-infected patients with new syphilis infections","volume":"18","author":"Buchacz","year":"2004","journal-title":"AIDS"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1097\/QAD.0b013e32830184df","article-title":"Neurosyphilis in a clinical cohort of HIV-1-infected patients","volume":"22","author":"Ghanem","year":"2008","journal-title":"AIDS"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1016\/j.amjmed.2005.11.016","article-title":"Ocular syphilis in HIV-positive patients receiving highly active antiretroviral therapy","volume":"119","author":"Balba","year":"2006","journal-title":"Am. J. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"381","DOI":"10.5694\/mja2.52258","article-title":"Australian consensus statement on doxycycline post-exposure prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual and other men who have sex with men","volume":"220","author":"Cornelisse","year":"2024","journal-title":"Med. J. Aust."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1177\/09564624241273801","article-title":"IUSTI Europe Guideline Board. IUSTI Europe position statement on use of DoxyPEP: June 2024","volume":"35","author":"Sherrard","year":"2024","journal-title":"Int. J. STD AIDS"},{"key":"ref_56","first-page":"62","article-title":"Common Patterns and Unique Threats in Antimicrobial Resistance as Demonstrated by Global Gonococcal Surveillance","volume":"30","author":"Rahman","year":"2024","journal-title":"Emerg. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/OLQ.0000000000001981","article-title":"Trends of Antimicrobial Susceptibility of Neisseria gonorrhoeae Isolates Between 2012 and 2023: Results from an Open Italian Cohort","volume":"51","author":"Lucente","year":"2024","journal-title":"Sex. Transm. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa2211934","article-title":"DoxyPEP Study Team. Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections","volume":"388","author":"Luetkemeyer","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/S1473-3099(24)00726-6","article-title":"DoxyPEP: Real-life effectiveness in a cohort of men who have sex with men in Milan, Italy","volume":"25","author":"Raccagni","year":"2025","journal-title":"Lancet Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1089\/apc.2023.0289","article-title":"Doxycycline as Postsexual Exposure Prophylaxis: Use, Acceptability, and Associated Sexual Health Behaviors Among a Multi-Site Sample of Clinical Trial Participants","volume":"38","author":"Fredericksen","year":"2024","journal-title":"AIDS Patient Care STDS"},{"key":"ref_61","unstructured":"Maci, C., Canetti, D., Tassan Din, C., Ballabio, C., Lucente, M.F., Catalano, G., Ponzoni, M., Foppa, C.U., Castagna, A., and Nozza, S. (2023, January 18\u201321). Malignant Syphilis mimicking lymphoma in HIV patient: A diagnostic challenge. Proceedings of the 19th European AIDS Conference, EACS 2023, Warsaw, Poland."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/5\/968\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:20:32Z","timestamp":1760030432000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/5\/968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,24]]},"references-count":61,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["microorganisms13050968"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13050968","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,24]]}}}