▼ Summary
– An 83-year-old married man presented with a rare form of secondary syphilis, a tricky bacterial infection to diagnose.
– He initially had facial paralysis and elevated liver enzymes, which were assumed to be from a viral infection but tested negative for multiple viruses.
– Doctors detailed their diagnostic process in a medical report, reaching the correct diagnosis without fully explaining the infection’s origin.
Medical professionals in Belgium recently faced a perplexing diagnostic challenge involving an elderly patient presenting with an unusual case of secondary syphilis. This situation highlights how syphilis can mimic other conditions, making accurate identification difficult even for experienced clinicians. The case involved an 83-year-old man who had been in a monogamous marriage for five decades and reported no recent sexual activity, particularly after undergoing cancer treatment.
The patient initially sought emergency care for intense itching, but his medical history revealed a more complex picture. A month earlier, he had been treated for one-sided facial paralysis, which resolved after steroid therapy. However, doctors remained concerned about persistently abnormal liver enzyme levels in his bloodwork. Initial testing ruled out numerous viral infections including HIV, Epstein-Barr virus, cytomegalovirus, and multiple forms of hepatitis.
When the man returned to the emergency department, his symptoms had expanded to include joint pain in his knees and ankles, general malaise, diminished appetite, and noticeable swelling in his feet and legs. The swelling occasionally affected his face, arms, and hands as well. These developing symptoms, combined with the unresolved liver issues, prompted physicians to look beyond their initial assumptions and consider less obvious explanations for his deteriorating health.
(Source: Ars Technica)