A Surprising Diagnosis: Syphilitic Gastritis and Hepatitis

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Presentation transcript:

A Surprising Diagnosis: Syphilitic Gastritis and Hepatitis Christian L. Horn, MD, Seyed Jalali, MD, Joel Abbott, DO, Michael T. Stein, MD The American Journal of Medicine Volume 131, Issue 10, Pages 1178-1181 (October 2018) DOI: 10.1016/j.amjmed.2018.03.023 Copyright © 2018 Terms and Conditions

Figure 1 (A) Esophagogastroduodenoscopy demonstrated multiple ulcers in the prepyloric area of the patient's stomach. (B) This is a close-up of a prepyloric ulcer. The American Journal of Medicine 2018 131, 1178-1181DOI: (10.1016/j.amjmed.2018.03.023) Copyright © 2018 Terms and Conditions

Figure 2 (A) Esophagogastroduodenoscopy revealed multiple serpiginous ulcers in the patient's duodenum. (B) The ulcers extended over a large area. The American Journal of Medicine 2018 131, 1178-1181DOI: (10.1016/j.amjmed.2018.03.023) Copyright © 2018 Terms and Conditions

Figure 3 (A) Immunohistochemical staining specific for Treponema pallidum identified numerous spirochetes in the gastric mucosa. They can be seen in this medium-power magnification of a gastric biopsy specimen. (B) This high-power magnification of the biopsy sample offers a closer look at the T. pallidum spirochetes. The American Journal of Medicine 2018 131, 1178-1181DOI: (10.1016/j.amjmed.2018.03.023) Copyright © 2018 Terms and Conditions

Figure 4 (A) Multiple prepyloric ulcers had resolved when this esophagogastroduodenoscopy image was obtained 2 months after treatment. (B) At the same time, esophagogastroduodenoscopy demonstrated only a single small healing duodenal ulcer. The American Journal of Medicine 2018 131, 1178-1181DOI: (10.1016/j.amjmed.2018.03.023) Copyright © 2018 Terms and Conditions