A Case Report of Secondary Syphilis Co-infected with Measles: A Diagnostic Dilemma with Fever and Rash
10
Issued Date
2022-05-01
Resource Type
eISSN
24146366
Scopus ID
2-s2.0-85130285836
Journal Title
Tropical Medicine and Infectious Disease
Volume
7
Issue
5
Rights Holder(s)
SCOPUS
Bibliographic Citation
Tropical Medicine and Infectious Disease Vol.7 No.5 (2022)
Suggested Citation
Imad H.A., Lakanavisid P., Pisutsan P., Trerattanavong K., Ngamprasertchai T., Matsee W., Piyaphanee W., Leaungwutiwong P., Nguitragool W., Nakayama E.E., Shioda T. A Case Report of Secondary Syphilis Co-infected with Measles: A Diagnostic Dilemma with Fever and Rash. Tropical Medicine and Infectious Disease Vol.7 No.5 (2022). doi:10.3390/tropicalmed7050070 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/84990
Title
A Case Report of Secondary Syphilis Co-infected with Measles: A Diagnostic Dilemma with Fever and Rash
Other Contributor(s)
Abstract
Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.