Cholestatic hepatitis due to secondary syphilis in an HIV patient: a case report

Abstract

Syphilis is a sexually transmitted disease caused by Treponema pallidum, and presents a variety of symptoms. Liver involvement in secondary syphilis is uncommon (1%), and can reach up to 3% in patients with HIV infection. We present the case of a 49-year-old man with the diagnosis of HIV on treatment with TARGA and an undetectable viral load, who attended the health center for jaundice, persistent headache, and hyperpigmented papular lesions on palms and soles. After laboratory tests and a cholangiopancreatography, the patient was diagnosed with cholestatic hepatitis due to secondary syphilis. The patient was treated with intravenous penicillin G sodium 3 million IU every 4 hours for 14 days, with a favorable clinical evolution and improvement of cholestasis.