Syphilis is a progressive
sexually transmitted infection that has a wide variety of presentations depending on the disease stage. These variable presentations can make it difficult to differentiate
syphilis from other diseases. While
tertiary syphilis is less common in the United States compared to primary or
secondary syphilis, recognition of the varied manifestations of advanced
syphilis can help providers accurately diagnose this disease to help prevent continued spread. In this case report, we present a patient with a history of bilateral palmar
wounds. The patient had presented to multiple emergency departments without a diagnosis of
syphilis. Upon subsequent emergency department visits, the patient was diagnosed with
tertiary syphilis, started on a course of
penicillin, and evaluated by dermatology. However, the patient left against medical advice prior to further evaluation and treatment. From this case report, we have learned the importance of considering
tertiary syphilis gummas in the differential diagnosis of atypical skin
wounds.
Topics: