Syphilitic Roseola in Human Immunodeficiency Virus-infected Homosexual: A Case Report

Abstract

BACKGROUND: Roseola syphilitica is one of the main manifestations of secondary syphilis. Syphilis is a sexually transmitted disease caused by Treponema pallidum. Syphilis and human immunodeficiency virus (HIV) infection can occur simultaneously and complicate the progression of the disease. HIV-syphilis coinfection is often cited as the main cause behind the increasing prevalence of syphilis among men who have sex with men (MSM).

CASE PRESENTATION: A 21-year-old man with HIV infection came with complaints of reddish spots on the face, genitalia, and palms of hands and feet that had appeared 3 weeks prior without itching or pain. The patient had a history of self-limiting red spots on his genitals 3 months prior. T. pallidum hemagglutination assay and veneral disease research laboratory serological examination showed titers of 1/10240 and 1/128. The patient was diagnosed with secondary syphilis and was given a single dose intramuscular injection of benzathine penicillin G 2.4 million units. Syphilis is often found together with HIV infection. The clinical picture of syphilis varies greatly, depending on the stage. In HIV patients, the clinical manifestations of syphilis are similar to non-HIV patients but the lesions are more aggressive. Serological tests are accurate and reliable for diagnosis and monitoring patient’s response to treatment. Until now, penicillin is still effective for treating syphilis but further physical and serological examinations are still needed for up to 24 months.

CONCLUSION: HIV infection in MSM is the most important factor causing syphilis. The diagnosis is made based on physical examination and blood serology. There is no difference in syphilis therapy between HIV patients and those who do not have HIV.