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

In this case report, we present two patients who were diagnosed with primary syphilis and exhibited atypical chief complaints.

Case 1 was a 47-year-old male patient who presented with a chief complaint of burning pain in the penis. He was initially diagnosed with infected genital burns due to edema in the foreskin and penile ulcers and treated using antibiotics. However, positive TPLA and RPR tests confirmed primary syphilis and the patient was treated using amoxicillin thereafter. The RPR titer was seen to decline after treatment and the penile ulcers healed.

Case 2 was a 43-year-old male patient who had previously undergone treatment for balanoposthitis using an antibacterial ointment. He then developed painless bilateral inguinal lymphadenopathy, suggesting malignant lymphoma. However, TPLA and RPR testing was carried out as balanoposthitis is often associated with painless lymphadenopathy. The positive results confirmed primary syphilis and the patient was treated using amoxicillin. The RPR titer was seen to decline thereafter and the inguinal lymph nodes became nonpalpable.