{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:13:52Z","timestamp":1785420832497,"version":"3.56.0"},"reference-count":13,"publisher":"Department of Medicine, Warren Alpert Medical School at Brown University","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Lues maligna is a rare form of secondary syphilis, which manifests as severe skin lesions and systemic symptoms. We report a case of a 54-year-old male, who had long standing history of human immune deficiency (HIV) infection. The patient presented with fever, chills, and fatigue, with associated ulcerated and scabbed nodules on the face, trunk, and extremities. He was not compliant with HIV treatment regimen and had previous history of treated syphilis. He was sexually active with a female partner. Work-up revealed elevated RPR titers (1:32), which was 1:1 five years prior. He was diagnosed with Lues maligna and was treated with 1 dose of intramuscular benzathine penicillin. Additionally, the lesions were superinfected with staphylococcus aureus which was treated. Syphilis presents a diagnostic challenge and remains the great imitator. Physicians should be vigilant of lues maligna diagnosis when skin lesions are suggestive.<\/jats:p>","DOI":"10.56305\/001c.72802","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T22:39:38Z","timestamp":1680302378000},"source":"Crossref","is-referenced-by-count":1,"title":["The Great Imitator: A Rare Case of Lues Maligna in an HIV-Positive Patient"],"prefix":"10.56305","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-015X","authenticated-orcid":false,"given":"Fadi","family":"Samaan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01aw9fv09","id-type":"ROR","asserted-by":"publisher"}],"name":"Rhode Island Hospital","department":["Division of Hospital Medicine, Department of Medicine"]},{"id":[{"id":"https:\/\/ror.org\/05gq02987","id-type":"ROR","asserted-by":"publisher"}],"name":"Brown University","department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"35509","published-online":{"date-parts":[[2023,4,1]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1093\/ofid\/ofx139","article-title":"Lues Maligna","volume":"4","author":"Russell A Johnson","year":"2017","journal-title":"Open Forum Infectious Diseases","ISSN":"https:\/\/id.crossref.org\/issn\/2328-8957","issn-type":"print"},{"issue":"1","key":"ref2","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1001\/archderm.1969.01610190076014","article-title":"Lues maligna. Presentation of a case and a review of the literature","volume":"99","author":"David A. Fisher","year":"1969","journal-title":"Archives of Dermatology","ISSN":"https:\/\/id.crossref.org\/issn\/0003-987X","issn-type":"print"},{"issue":"7","key":"ref3","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1111\/ced.13625","article-title":"Syphilis screening before initiation of immunosuppressive and biologic therapy for psoriasis and psoriatic arthritis","volume":"43","author":"N. K. Kansal","year":"2018","journal-title":"Clinical and Experimental Dermatology","ISSN":"https:\/\/id.crossref.org\/issn\/0307-6938","issn-type":"print"},{"issue":"4","key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually Transmitted Infections Treatment Guidelines, 2021","volume":"70","author":"Kimberly A. Workowski","year":"2021","journal-title":"MMWR. Recommendations and Reports","ISSN":"https:\/\/id.crossref.org\/issn\/1057-5987","issn-type":"print"},{"issue":"12","key":"ref5","doi-asserted-by":"publisher","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":"Yevgeniy Balagula","year":"2014","journal-title":"International Journal of Dermatology","ISSN":"https:\/\/id.crossref.org\/issn\/0011-9059","issn-type":"print"},{"issue":"5","key":"ref6","doi-asserted-by":"publisher","first-page":"344","DOI":"10.4103\/idoj.idoj_277_17","article-title":"Lues Maligna in an Immunocompetent Female","volume":"9","author":"Swetalina Pradhan","year":"2018","journal-title":"Indian Dermatology Online Journal","ISSN":"https:\/\/id.crossref.org\/issn\/2229-5178","issn-type":"print"},{"issue":"12","key":"ref7","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1056\/nejm197703242961220","article-title":"Syphilis maligna praecox--the first patient seen at MGH in 1821","volume":"296","author":"D J Cripps","year":"1977","journal-title":"New England Journal of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2050313X1773105","DOI":"10.1177\/2050313x17731050","article-title":"The great impostor: Lues maligna in an HIV-infected male","volume":"5","author":"Alfredo J Mena Lora","year":"2017","journal-title":"SAGE Open Medical Case Reports","ISSN":"https:\/\/id.crossref.org\/issn\/2050-313X","issn-type":"print"},{"issue":"10","key":"ref9","doi-asserted-by":"publisher","first-page":"e930","DOI":"10.1016\/j.ijid.2013.03.020","article-title":"Malignant syphilis","volume":"17","author":"Keshavamurthy Vinay","year":"2013","journal-title":"International Journal of Infectious Diseases","ISSN":"https:\/\/id.crossref.org\/issn\/1201-9712","issn-type":"print"},{"issue":"3","key":"ref10","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1111\/j.1346-8138.2005.tb00749.x","article-title":"Lues maligna in a chronic alcoholic patient","volume":"32","author":"Dilek Bayramg\u00fcrler","year":"2005","journal-title":"The Journal of Dermatology","ISSN":"https:\/\/id.crossref.org\/issn\/0385-2407","issn-type":"print"},{"issue":"5 suppl 1","key":"ref11","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1590\/abd1806-4841.20164491","article-title":"Early malignant syphilis","volume":"91","author":"Yara Martins Ortigosa","year":"2016","journal-title":"Anais Brasileiros de Dermatologia","ISSN":"https:\/\/id.crossref.org\/issn\/0365-0596","issn-type":"print"},{"issue":"8","key":"ref12","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1097\/olq.0b013e3181a2a946","article-title":"Lues maligna in early HIV infection case report and review of the literature","volume":"36","author":"Joseph D. Tucker","year":"2009","journal-title":"Sexually Transmitted Diseases","ISSN":"https:\/\/id.crossref.org\/issn\/0148-5717","issn-type":"print"},{"issue":"1","key":"ref13","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1186\/s13000-015-0419-5","article-title":"Human immunodeficiency virus-positive secondary syphilis mimicking cutaneous T-cell lymphoma","volume":"10","author":"Michiko Yamashita","year":"2015","journal-title":"Diagnostic Pathology","ISSN":"https:\/\/id.crossref.org\/issn\/1746-1596","issn-type":"print"}],"container-title":["Journal of Brown Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bhm.scholasticahq.com\/article\/72802-the-great-imitator-a-rare-case-of-lues-maligna-in-an-hiv-positive-patient","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T13:36:53Z","timestamp":1739885813000},"score":1,"resource":{"primary":{"URL":"https:\/\/bhm.scholasticahq.com\/article\/72802-the-great-imitator-a-rare-case-of-lues-maligna-in-an-hiv-positive-patient"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.56305\/001c.72802","relation":{},"ISSN":["2994-5593"],"issn-type":[{"value":"2994-5593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,1]]}}}