Thyroid gland involvement in secondary syphilis: a case report

ABSTRACT

Background

Syphilis is a systemic, infectious disease caused by Treponema pallidum and is notorious for the variety of its clinical presentations.

Objective

We report a case of secondary syphilis with thyroid gland and ocular involvement in a human immunodeficiency virus (HIV) negative patient.

Methods

We present the patient’s history, clinical findings, laboratory test results, imaging and management.

Results

A 39-year-old Caucasian, HIV unaffected woman presented with acute midline neck swelling, dyspnea and difficulty to talk or swallow. Serologic tests for syphilis were positive. PCR performed on a thyroid fine needle aspiration cytology (FNAC) aspirate was positive for Treponema pallidum. Skin lesions and unilateral loss of vision were present. Treatment with intravenous benzyl-penicillin showed a good regression of symptoms.

Conclusion

We report an unusual case of thyroid swelling in a secondary syphilis infection. Awareness of syphilis as a differential diagnosis is important in a risk population.

KEYWORDS:

• Treponema pallidum
• syphilis
• thyroid gland
• PCR
• ocular

Acknowledgments

Hilde Smets, Reference Laboratory HIV/STD at the ITM for her work on the rtPCR for T. pallidum.

Disclosure statement

No potential conflict of interest was reported by the authors.