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1
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Tsakos E, Xydias EM, Ziogas AC, Zarampouka K, Gerou S, Tsagias N, Bimpa K. Extensive Peritoneal and Pelvic Granulomatous Inflammation Due to Syphilis Infection Manifesting as Primary Infertility: A Case Report. Cureus 2024; 16:e70764. [PMID: 39380781 PMCID: PMC11461030 DOI: 10.7759/cureus.70764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2024] [Indexed: 10/10/2024] Open
Abstract
Infertility affects millions of couples worldwide and can result from various factors, including sexually transmitted infections. Although syphilis is known to contribute to a small number of infertility cases through chronic pelvic inflammatory disease, which ultimately impairs fertility, detailed descriptions of such cases are limited. In this report, we present a case of primary infertility caused by extensive peritoneal granulomatous inflammation, adhesions, and tubal obstruction resulting from syphilis.
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Affiliation(s)
- Elias Tsakos
- Department of Obstetrics and Gynecology, EmbryoClinic IVF, Thessaloniki, GRC
| | - Emmanouil M Xydias
- Department of Obstetrics and Gynecology, EmbryoClinic IVF, Thessaloniki, GRC
| | - Apostolos C Ziogas
- Department of Obstetrics and Gynecology, University of Thessaly, Larissa, GRC
| | | | - Spyridon Gerou
- Department of Biopathology, Analysi Iatriki SA, Thessaloniki, GRC
| | - Nikolaos Tsagias
- Department of Obstetrics and Gynecology, EmbryoClinic IVF, Thessaloniki, GRC
| | - Kanelina Bimpa
- Department of Breast Surgery, EmbryoClinic IVF, Thessaloniki, GRC
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2
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Guerrero Muñoz C, Castañeda Agredo A, Romero Valle MJ, Silva Silva AM, León del Campo M, Azpirtarte Sánchez C, Domínguez Fraga M, Milán Pilo MV, Polo Lorduy BA, González Guirado A, Martín Relloso MJ, Sánchez-Fayos Calabuig P, Bosch Esteva O. Beyond Tumors: Gastric Syphilis Emulating a Gastric Neoplasia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:629. [PMID: 38674276 PMCID: PMC11052094 DOI: 10.3390/medicina60040629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
We present the case of a 35-year-old male with a first-degree family history of gastric cancer (his father was diagnosed at the age of 45), who was presumed to have gastric cancer himself when evaluating the features of his upper endoscopy performed after hematemesis. Surprisingly, no cancer cells were found in the biopsies. Thanks to a different diagnostic suspicion subsequent to performing a full clinical history, a more favorable diagnosis was reached: gastric syphilis.
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Affiliation(s)
- Claudia Guerrero Muñoz
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Andres Castañeda Agredo
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Maria Jose Romero Valle
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Andrés Mauricio Silva Silva
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Marta León del Campo
- Department of Pathology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | | | - Marta Domínguez Fraga
- Department of Radiology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Manuel Vicente Milán Pilo
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Benjamin Arturo Polo Lorduy
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Agustina González Guirado
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - María Jesus Martín Relloso
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Paloma Sánchez-Fayos Calabuig
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
| | - Orencio Bosch Esteva
- Department of Gastroenterology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (C.G.M.); (M.J.R.V.); (A.M.S.S.); (M.V.M.P.); (B.A.P.L.); (A.G.G.); (M.J.M.R.); (P.S.-F.C.); (O.B.E.)
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3
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Sinagra E, Macaione I, Stella M, Shahini E, Maida M, Pompei G, Rossi F, Conoscenti G, Alloro R, Di Ganci S, Ricotta C, Testai S, Marasà M, Scarpulla G, Rizzo AG, Raimondo D. Gastric Syphilis Presenting as a Nodal Inflammatory Pseudotumor Mimicking a Neoplasm: Don’t Forget the Treponema! Case Report and Scoping Review of the Literature of the Last 65 Years. GASTROENTEROLOGY INSIGHTS 2023; 14:178-190. [DOI: 10.3390/gastroent14020014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
Despite the fact that gastric syphilis is considered rare, it is reported as a type of organic involvement that is present in a large proportion of secondary syphilis cases, even though gastritis presenting with symptoms is extremely rare. Clinical, radiological, and endoscopic findings are non-specific and frequently mimic the symptoms of gastric adenocarcinoma or lymphoma, making diagnosis difficult. Immunostaining is required for this diagnosis. We would like to emphasize the importance of being suspicious of GS when a gastric mass exhibits the histologic features of an inflammatory pseudotumor (IPT), as previously reported for nodal IPT caused by luetic infection. We described a 56-year-old man who presented to the oncology department with a 3-month history of anorexia, epigastric pain, nausea, vomiting, and weight loss, as well as an initial radiological and endoscopic suspicion of gastric adenocarcinoma, in which immune staining allowed us to diagnose GS. In addition, we conducted an updated scoping review of the scientific literature to show the clinical, laboratory, and therapeutic findings in GS patients over the last 65 years.
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Affiliation(s)
- Emanuele Sinagra
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Ina Macaione
- Mini-Invasivecolorectal & Pancreatic Surgery Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Mario Stella
- Pathology Unit, Az. Osp. Ospedali Riuniti “Villa Sofia-Cervello”, Via Trabucco 180, 90146 Palermo, Italy
| | - Endrit Shahini
- Gastroenterology Unit, National Institute of Gastroenterology-IRCCS “Saverio de Bellis”, Castellana Grotte, 70013 Bari, Italy
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
| | - Giancarlo Pompei
- Pathology Unit, Sant’Antonio Abate Hospital, Via Cosenza 82, 91016 Casa Santa, Italy
- Pathology Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Francesca Rossi
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Giuseppe Conoscenti
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Rita Alloro
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Simona Di Ganci
- Mini-Invasivecolorectal & Pancreatic Surgery Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Calogero Ricotta
- Mini-Invasivecolorectal & Pancreatic Surgery Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Sergio Testai
- Radiology Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Marta Marasà
- Radiology Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Giuseppe Scarpulla
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
- Radiology Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Aroldo Gabriele Rizzo
- Pathology Unit, Az. Osp. Ospedali Riuniti “Villa Sofia-Cervello”, Via Trabucco 180, 90146 Palermo, Italy
| | - Dario Raimondo
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli–G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
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Assarzadegan N, Fang JM, Voltaggio L, Riddell RH, Montgomery EA, McDonald OG, Coates R, Carneiro F, Lauwers GY, Kamionek M, Lamps LW, Westerhoff M. Histologic Features of Syphilitic Gastritis: A Rare but Resurging Imitator of Common Diseases. Am J Clin Pathol 2023; 159:263-273. [PMID: 36702577 PMCID: PMC10452963 DOI: 10.1093/ajcp/aqac153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/03/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES The range of histopathologic features of gastric syphilis is not well described. Here we describe the clinicopathologic findings of eight patients with syphilitic gastritis. METHODS A search of our Pathology Data System (2003-2022) and multiple other institutions identified eight patients with syphilitic gastritis. Clinical information, pathology reports, and available slides were reviewed. RESULTS Lesions predominated in middle-aged adults (mean age, 47.2 years; range, 23-61 years) with a propensity for men (n = 7). Three patients had a documented history of human immunodeficiency virus. Clinical presentations included weight loss, abdominal pain, hematochezia, fever, dyspepsia, nausea and vomiting, hematemesis, anemia, and early satiety. Endoscopic findings included ulcerations, erosions, abnormal mucosa, and nodularity. All specimens shared an active chronic gastritis pattern with intense lymphohistiocytic infiltrates, variable plasma cells, and gland loss. Prominent lymphoid aggregates were seen in four specimens. The diagnosis was confirmed either by immunostain for Treponema pallidum (n = 7) or by direct immunofluorescence staining and real-time polymerase chain reaction (n = 1). All patients with available follow-up data showed resolution of symptoms after antibiotic therapy (n = 4). CONCLUSIONS Recognition of the histologic pattern of syphilitic gastritis facilitates timely treatment, prevents further transmission, and avoids unnecessarily aggressive treatment.
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Affiliation(s)
| | - Jiayun M Fang
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Lysandra Voltaggio
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert H Riddell
- Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | | | - Oliver G McDonald
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ryan Coates
- Mountain States Pathology, Colorado Springs, CO, USA
| | - Fatima Carneiro
- Institute of Molecular Pathology and Immunology of the University of Porto, Faculty of Medicine of the University of Porto, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Gregory Y Lauwers
- Department of Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Laura W Lamps
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Maria Westerhoff
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
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A Giant Syphilitic Gastric Ulcer. ACG Case Rep J 2022; 9:e00819. [PMID: 35837243 PMCID: PMC9276104 DOI: 10.14309/crj.0000000000000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
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Lan YM, Yang SW, Dai MG, Ye B, He FY. Gastric syphilis mimicking gastric cancer: A case report. World J Clin Cases 2021; 9:7798-7804. [PMID: 34621829 PMCID: PMC8462240 DOI: 10.12998/wjcc.v9.i26.7798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/14/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The nonspecific clinical, radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases. The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.
CASE SUMMARY A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week, which was aggravated for two days. The patient had been sexually active with the same male partner for the past years, but her partner was promiscuous. Abdominal contrast-enhanced computed tomography (CT) and positron emission tomography/CT suggested gastric cancer. The gastroscopy revealed an antral gastric ulcer with gastric retention, and also suggested gastric cancer. But no cancer cells were found in the biopsies taken during the two gastroscopies. Treponema pallidum (T. pallidum) antibodies: ELISA positive, rapid plasma reagin titer 1:16. Hematoxylin and eosin (HE) stain showed macrophage infiltration in the lamina propria. Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T. pallidum. The patient was finally diagnosed with gastric syphilis.
CONCLUSION Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer. Penicillin can relieve symptoms of gastric syphilis.
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Affiliation(s)
- Yan-Mei Lan
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Shang-Wen Yang
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Mu-Gen Dai
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Bin Ye
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Fei-Yun He
- Department of Gastroenterology, Lishui Chinese Medicine Hospital, Lishui 323000, Zhejiang Province, China
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7
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Lacerda PN, Campos LM, de Ré MR, Miot HA. Cutaneous hyperpigmentation and megaloblastic anemia as manifestations of gastric syphilis. Int J Dermatol 2021; 60:e356-e358. [PMID: 33719066 DOI: 10.1111/ijd.15535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/03/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Priscila N Lacerda
- Departamento de Dermatologia e Radioterapia, FMB-UNESP, Botucatu, Brazil
| | - Luana M Campos
- Departamento de Dermatologia e Radioterapia, FMB-UNESP, Botucatu, Brazil
| | - Mariana R de Ré
- Departamento de Dermatologia e Radioterapia, FMB-UNESP, Botucatu, Brazil
| | - Hélio A Miot
- Departamento de Dermatologia e Radioterapia, FMB-UNESP, Botucatu, Brazil
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