Osteolytic lesions in secondary syphilis.

A 37-year-old man was admitted with bone pain, night sweats, and skin lesions typical of secondary syphilis. His VDRL and FTA-ABS tests were reactive. Roentgenograms of the tibiae, fibulae, radii, and ulnae showed osteolytic lesions. A tibial biopsy examination showed bone necrosis, prominent vascularity, swollen endothelial cells, an intense plasma cell infiltrate, and numerous spirochetes. All manifestations responded to penicillin therapy. There have been few reports of osteolytic lesions in secondary syphilis. This is the first known case in which such involvement was unequivocally proven by histopathology with the demonstration of spirochetes.