Osteitis in the dens of axis caused by Treponema pallidum

TY - JOUR

T1 - Osteitis in the dens of axis caused by Treponema pallidum

AU - Fabricius, Thilde

AU - Winther, Charlotte

AU - Ewertsen, Caroline

AU - Kemp, Michael

AU - Nielsen, Susanne Dam

PY - 2013/7/26

Y1 - 2013/7/26

N2 - Background: Syphilis has been referred to as " the great imitator" due to its ability to imitate other diseases. Untreated syphilis becomes a systemic infection that can involve almost every organ systems. Treponema pallidum has a high affinity for bone tissue, but osteitis has mainly been described in late stages of the disease. Vertebral involvement is rare, and this is to our knowledge the first case describing syphilitic spondylitis in early acquired syphilis.Case presentation: We here describe destructive osteitis in the vertebral column as the initial manifestation of early acquired syphilis in a 24-year-old caucasian homosexual male with HIV infection. The diagnosis was reached by universal bacterial PCR and DNA sequencing of the DNA product. It was confirmed by PCR specific for Treponema pallidum, immunohistochemistry and detection of increasing antibody titer.Conclusions: As syphilis has re-emerged in Western countries and remains a worldwide common disease it is important to have in mind as a causative agent of skeletal symptoms, especially among HIV-infected individuals or men who have sex with men (MSM).

AB - Background: Syphilis has been referred to as " the great imitator" due to its ability to imitate other diseases. Untreated syphilis becomes a systemic infection that can involve almost every organ systems. Treponema pallidum has a high affinity for bone tissue, but osteitis has mainly been described in late stages of the disease. Vertebral involvement is rare, and this is to our knowledge the first case describing syphilitic spondylitis in early acquired syphilis.Case presentation: We here describe destructive osteitis in the vertebral column as the initial manifestation of early acquired syphilis in a 24-year-old caucasian homosexual male with HIV infection. The diagnosis was reached by universal bacterial PCR and DNA sequencing of the DNA product. It was confirmed by PCR specific for Treponema pallidum, immunohistochemistry and detection of increasing antibody titer.Conclusions: As syphilis has re-emerged in Western countries and remains a worldwide common disease it is important to have in mind as a causative agent of skeletal symptoms, especially among HIV-infected individuals or men who have sex with men (MSM).

U2 - 10.1186/1471-2334-13-347

DO - 10.1186/1471-2334-13-347

M3 - Journal article

C2 - 23885957

SN - 1471-2334

VL - 13

JO - B M C Infectious Diseases

JF - B M C Infectious Diseases

M1 - 347

ER -