Pizzarossa Ana Carina, Rebella Martín
Clínica Médica C, Hospital de Clínicas, Montevideo, Uruguay.
BMJ Case Rep. 2019 Jan 28;12(1):bcr-2018-226918. doi: 10.1136/bcr-2018-226918.
We present the case of a patient who sought treatment for fever and a maculopapular rash involving the trunk, limbs, palms and soles. The patient also presented with hepatomegaly and elevated levels of liver enzymes (with a higher increase of alkaline phosphatase). With the proposal of early syphilitic hepatitis, during the stage of secondary syphilis, a venereal disease research laboratory and haemagglutination tests were requested, which confirmed the diagnosis. All altered parameters improved with antibiotic treatment for secondary syphilis. Syphilitic hepatitis is an often overlooked presentation of syphilis and should be considered as a differential diagnosis in patients with elevated levels of liver enzymes and risk factors for syphilis.
我们报告了一例患者，该患者因发热以及躯干、四肢、手掌和足底出现斑丘疹而寻求治疗。患者还出现肝肿大和肝酶水平升高（碱性磷酸酶升高更为明显）。鉴于考虑为二期梅毒阶段的早期梅毒性肝炎，我们进行了性病研究实验室检查和血凝试验，结果证实了诊断。经针对二期梅毒的抗生素治疗后，所有异常参数均有所改善。梅毒性肝炎是梅毒一种常被忽视的表现，对于肝酶水平升高且有梅毒危险因素的患者应将其视为鉴别诊断之一。
