Coyne K, Browne R, Anagnostopoulos C, Nwokolo N
Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
Int J STD AIDS. 2006 Jun;17(6):421-3. doi: 10.1258/095646206777323355.
A 36-year-old man presented for an HIV test, which answered positive. He gave a six-week history of headache and fever. His syphilis serology was also positive with a Venereal Disease Research Laboratory (VDRL) titre of 1:32, and positive Treponema pallidum particle agglutination (TPPA) assay and fluorescent treponemal antibody (FTA). When he attended for treatment of the syphilis, he had developed severe pain in both lower limbs. Plain radiographs were normal. An isotope bone scan showed multiple areas of increased uptake, consistent with syphilitic periostitis. Some of these lesions were asymptomatic. He was treated with benzathine penicillin and his pain resolved. The bone scan had normalized after six months. We review the previous literature regarding syphilitic bone pain and periostitis. We discuss the importance of considering syphilis in the differential diagnosis of any sexually active adult presenting with bone pain, and highlight the usefulness of isotope bone scans in clarifying the clinical picture.
一名36岁男性前来进行HIV检测，结果呈阳性。他有六周的头痛和发热病史。他的梅毒血清学检查也呈阳性，性病研究实验室（VDRL）滴度为1:32，梅毒螺旋体颗粒凝集试验（TPPA）和荧光密螺旋体抗体（FTA）均为阳性。当他前来治疗梅毒时，双下肢出现了严重疼痛。X线平片正常。同位素骨扫描显示多个摄取增加区域，符合梅毒性骨膜炎表现。其中一些病变无症状。他接受了苄星青霉素治疗，疼痛缓解。六个月后骨扫描恢复正常。我们回顾了以往关于梅毒性骨痛和骨膜炎的文献。我们讨论了在对任何出现骨痛的性活跃成年人进行鉴别诊断时考虑梅毒的重要性，并强调了同位素骨扫描在明确临床情况方面的作用。
