Atypical presentations of primary genital syphilis in HIV-negative homosexually active men: a case series

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Abstract

We report four cases of primary syphilis of the penis in HIV-negative men having unprotected insertive oral sexual intercourse with men. Patients presented with atypical penile lesions mimicking genital herpes, balanitis, lichen planus and fi xed drug eruption. Syphilis should be considered in the differential diagnosis of other genital diseases, both sexually or non-sexually transmitted. Considering the increasing incidence of atypical manifestations of syphilis, serological tests for syphilis should also be performed more often.

1. DiCarlo RP, Martin DH. Th e clinical diagnosis of genital ulcer disease in men. Clin Infect Dis 1997;25:292-8.

2. Behets FM, Andriamiadana J, Randrianasolo D, Randriamanga R, Rasamilalao D, Chan CY, et al. Chancroid, primary syphilis, genital herpes, and lymphogranuloma venereum in Antananarivo, Madagascar. J Infect Dis 1999;180:1382-5.

3. Ahmed HJ, Mbwana J, Gunnarsson E, Ahlman K, Guerino C, Svensson LA, et al. Etiology of genital ulcer disease and association with human immunodefi ciency virus infection in two Tanzanian cities. Sex Transm Dis 2003;30:114-9.

4. Pebody RG, Andrews N, Brown D, Gopal R, De Melker H, François G, et al. Th e seroepidemiology of herpes simplex virus type 1 and 2 in Europe. Sex Transm Infect 2004;80:185-91.

5. Hope-Rapp E, Anyfantakis V, Fouéré S, Bonhomme P, Louison JB, de Marsac TT, et al. Etiology of genital ulcer disease. A prospective study of 278 cases seen in an STD clinic in Paris. Sex Transm Dis 2010;37:153-8.

6. Federal Institute of Statistics. Demographic statistics. Belgrade: Federal Institute of Statistics: 1972-2004.

7. Vlajinac H, Sipetic S, Bjekic M, Savcic G, Marinkovic J. Outbreak of early syphilis in an institution for the care of adults with mental disorders. Epidemiol Infect 2006;134:585-8.

8. Lacey HB, Higgins SP, Graham D. An outbreak of early syphilis: cases from North Manchester General Hospital. Sex Transm Infect 2001;77:311-3.

9. Lynn WA, Lightman S. Syphilis and HIV: a dangerous combination. Lancet Infect Dis 2004;4:456-66.

10. Centers for Disease Control and Prevention (CDC). Transmission of primary and secondary syphilis by oral sex - Chicago, Illinois, 1998-2002. MMWR Morb Mortal Wkly Rep 2004;53: 966-8.

11. Communicable Disease Surveillance Centre. Increased transmission of syphilis in Brighton and Greater Manchester among men who have sex with men. Commun Dis Rep CDR Wkly 2000;10: 386.

12. Anderson J, Mindel A, Tovey SJ, Williams P. Primary and secondary syphilis, 20 years` experience. 3: Diagnosis, treatment and follow up. Genitourin Med 1989;65: 239-43.

13. Fiumara NJ. Reinfection primary, secondary, and latent syphilis: the serologic response after treatment. Sex Transm Dis 1980;7: 111-5.

Serbian Journal of Dermatology and Venereology

The Journal of Serbian Association of Dermatovenereologists (SAD)

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