Case Reports
Syphilis Mimicking Reiter’s Syndrome in an HIV-Positive Patient

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ABSTRACT

A 38-year-old man with HIV infection presented with panuveitis, urethritis, and a papulosquamous eruption on his palms and soles. Careful physical and laboratory examination led to the diagnosis of syphilitic keratoderma, uveitis, and balanitis. The patient was successfully treated with penicillin and prednisone therapy. Because the initial presentation was difficult to distinguish from the symptoms of Reiter’s syndrome, a high degree of clinical suspicion was required to accurately diagnose syphilis, a curable and potentially fatal disease.

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Case Report

A 38-year-old Puerto Rican man presented to the–hospital with worsening blurred vision, injected sclera, and photophobia. Ten months earlier, he experienced floaters in his left eye. Seven months prior to presentation, he noted painful lesions on his tongue. At that time he also developed a scaling rash on the palms and soles, which was intermittently painful and pruritic, as well as a painless ulcer and rash on his penis and scrotum, accompanied by dysuria. Concurrently, he developed blurry

Discussion

This case is noteworthy in that it is only the second reported case of syphilis in an HIV-positive patient in which the symptoms of syphilis closely resemble those of Reiter’s syndrome.3 The triad of uveitis, urethritis, and skin rash correlated with coinfection with syphilis and HIV. The eye and skin manifestations of syphilis include uveitis and a diffuse maculopapular rash, which are often more aggressive and atypical in the HIV patient.1 These atypical findings, together with a higher rate

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