JPGN reports · 5 authors, 3 centres
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This is a case report describing a 19-year-old male who presented with acute hepatitis and was diagnosed with secondary syphilitic hepatitis after exclusion of other causes. The case highlights the importance of screening for syphilis in sexually active adolescents with unexplained acute hepatitis.
The report details the case of a 19-year-old male presenting with jaundice, abdominal pain, and significantly elevated transaminases. Extensive workup ruled out common viral, autoimmune, and metabolic causes of hepatitis. A history of a recent rash and penile ulcer prompted syphilis testing, which was positive, leading to a diagnosis of secondary syphilitic hepatitis. Treatment with intramuscular penicillin resulted in a rapid and marked improvement in liver enzymes and bilirubin levels within one month, with normalization by four months. The authors emphasize that while syphilitic hepatitis is rare, its nonspecific presentation requires clinicians to maintain a high index of suspicion, especially in sexually active adolescents, to ensure prompt diagnosis and prevent disease progression and transmission.
