A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash
Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etio...
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| Format: | Article |
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MDPI AG
2022-05-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/7/5/70 |
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| author | Hisham Ahmed Imad Ploi Lakanavisid Phimphan Pisutsan Kentaro Trerattanavong Thundon Ngamprasertchai Wasin Matsee Watcharapong Piyaphanee Pornsawan Leaungwutiwong Wang Nguitragool Emi E. Nakayama Tatsuo Shioda |
| author_facet | Hisham Ahmed Imad Ploi Lakanavisid Phimphan Pisutsan Kentaro Trerattanavong Thundon Ngamprasertchai Wasin Matsee Watcharapong Piyaphanee Pornsawan Leaungwutiwong Wang Nguitragool Emi E. Nakayama Tatsuo Shioda |
| author_sort | Hisham Ahmed Imad |
| collection | DOAJ |
| description | Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for <i>Treponema pallidum</i>. Here we describe the clinical course and management of this patient. |
| first_indexed | 2024-03-10T01:41:32Z |
| format | Article |
| id | doaj.art-95ab8f4430714ad592b8c9cc08ae5102 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-10T01:41:32Z |
| publishDate | 2022-05-01 |
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| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-95ab8f4430714ad592b8c9cc08ae51022023-11-23T13:23:40ZengMDPI AGTropical Medicine and Infectious Disease2414-63662022-05-01757010.3390/tropicalmed7050070A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and RashHisham Ahmed Imad0Ploi Lakanavisid1Phimphan Pisutsan2Kentaro Trerattanavong3Thundon Ngamprasertchai4Wasin Matsee5Watcharapong Piyaphanee6Pornsawan Leaungwutiwong7Wang Nguitragool8Emi E. Nakayama9Tatsuo Shioda10Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandThai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandThai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandHull York Medical School, University Road, Heslington, York, YO10 5DD, UKThai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandThai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandThai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandTropical Medicine Diagnostic Reference Laboratory, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandMahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandCenter for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, JapanCenter for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, JapanFever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for <i>Treponema pallidum</i>. Here we describe the clinical course and management of this patient.https://www.mdpi.com/2414-6366/7/5/70measles virusexanthema<i>Treponema pallidum</i>secondary syphilis |
| spellingShingle | Hisham Ahmed Imad Ploi Lakanavisid Phimphan Pisutsan Kentaro Trerattanavong Thundon Ngamprasertchai Wasin Matsee Watcharapong Piyaphanee Pornsawan Leaungwutiwong Wang Nguitragool Emi E. Nakayama Tatsuo Shioda A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash Tropical Medicine and Infectious Disease measles virus exanthema <i>Treponema pallidum</i> secondary syphilis |
| title | A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash |
| title_full | A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash |
| title_fullStr | A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash |
| title_full_unstemmed | A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash |
| title_short | A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash |
| title_sort | case report of secondary syphilis co infected with measles a diagnostic dilemma with fever and rash |
| topic | measles virus exanthema <i>Treponema pallidum</i> secondary syphilis |
| url | https://www.mdpi.com/2414-6366/7/5/70 |
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