日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

We report a case of early syphilis with liver dysfunction and systemic lymphadenopathy. A 40-year-old man visited the hospital for the swelling of lymph node in the right groin and edema of the right lower limb. He had liver dysfunction, and swelling of bilateral inguinal lymph nodes; computed tomography revealed swelling of the bilateral inguinal lymph nodes and peritoneal lymphadenopathy. However, a biopsy of the right inguinal lymph node showed nonspecific inflammation; ulcerative lesion was observed in the scrotum. Rapid plasma reagin (RPR) and T. pallidum latex agglutination tests were positive; therefore, we established a diagnosis of early syphilis. Oral amoxicillin and probenecid were effective. Eight weeks after starting oral administration, the RPR test decreased by 75%. All the symptoms resolved. We conclude that syphilis diagnosis requires physical examination and history taking.