A Case of Syphilis Diagnosed from a Cervical Lymph Node Swelling

Abstract

Syphilis is a systemic infectious disease caused by Treponema pallidum, resulting in specific symptoms. We experienced a case of syphilis in a 57-year-old woman whose complaint was cervical lymphadenopathy. Both the syphilis qualitative blood tests (TPLA and RPR) were positive and the serum soluble IL-2R level was 1,300 U/L. A cervical lymph node biopsy was performed, the results of which demonstrated a granulomatous lesion consistent with syphilis lymphadenitis.

The number of syphilis patients in Japan has been rapidly increasing since 2010, mainly in the metropolitan area and a warning announcement was issued from the Japanese Society for Sexually Transmitted Infections in 2016. Both mucosal plaque and angular cheilitis are typical, but not specific findings. In any case, with lymphadenopathy as the sole symptom, detailed medical history inquiry sometimes leads to the diagnosis.