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

Herein, we report a case of syphilis with generalized lymphadenopathy and pulmonary nodules. A man in his 30s presented to our clinic with complaints of ulceration on his penis and swelling in the left inguinal region. He noticed a growth on his penis two months ago but left it untreated. Additionally, he visited several sex establishments 3–4 months prior to seeking treatment. We observed elevated RPR and TPLA levels, and computed tomography revealed a 4-cm lymph node in the left inguinal region, as well as swelling of the left iliac and para-aortic lymph nodes. Further, nodular lesions were also observed in the peripheral region of the right lung. We diagnosed him with secondary syphilis and commenced treatment with oral amoxicillin at 1500 mg per day. After an 8-week treatment, we observed a steady decline in RPR levels, and his CT findings improved. Given the increase in syphilis cases in recent years, it is important to consider a potential rise in instances with progressive symptoms.