BACKGROUND: The aim of this study is to report two patients with osteitis in secondary syphilis. The increase in the number of cases of syphilis, linked to the changes in sexual behavior and to the increase of immigrants from areas of high prevalence of STD, as well as its relationship with HIV infection, makes important to clinicians become aware of unusual presentation of secondary syphilis. PATIENTS: We report two patients diagnosed of secondary syphilis, one of them with HIV infection. Both showed dermatological lesions in palms and soles, malaise and fever. Bone scintigraphy showed significant uptake in parietal and frontal bones in both patients. Clinical response was quickly achieved after penicillin treatment. CONCLUSIONS: In patients with secondary syphilis and osteoarticular symptoms luetic osteitis must be included in differential diagnosis. Bone scintigraphy should be the first diagnostic tool because it possibilities to perform a total body scan which allows localizing asymptomatic lesions. Moreover bone scan shows a high sensitivity.
BACKGROUND: The aim of this study is to report two patients with osteitis in secondary syphilis. The increase in the number of cases of syphilis, linked to the changes in sexual behavior and to the increase of immigrants from areas of high prevalence of STD, as well as its relationship with HIV infection, makes important to clinicians become aware of unusual presentation of secondary syphilis. PATIENTS: We report two patients diagnosed of secondary syphilis, one of them with HIV infection. Both showed dermatological lesions in palms and soles, malaise and fever. Bone scintigraphy showed significant uptake in parietal and frontal bones in both patients. Clinical response was quickly achieved after penicillin treatment. CONCLUSIONS: In patients with secondary syphilis and osteoarticular symptoms luetic osteitis must be included in differential diagnosis. Bone scintigraphy should be the first diagnostic tool because it possibilities to perform a total body scan which allows localizing asymptomatic lesions. Moreover bone scan shows a high sensitivity.