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Case Reports in Infectious Diseases - Volume 2016 2016, Article ID 7420938, 4 pages -

Case ReportCHI Health Creighton University Medical Center, Omaha, NE, USA

Received 14 September 2016; Accepted 16 November 2016

Academic Editor: Antonella Marangoni

Copyright © 2016 Felicia Ratnaraj et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Tenosynovitis, inflammation of a tendon and its synovial sheath, is a rare manifestation of secondary syphilis and if diagnosed early is reversible. Background. A 52-year-old male with past medical history of untreated syphilis presented with gradual onset of swelling and pain of the right fourth metacarpophalangeal joint MCP. He reported a history of painless penile lesions after having sexual intercourse with a new partner approximately five months ago which was treated with sulfamethoxazole-trimethoprim. An RPR done at that time came back positive with a high titer; however, patient was lost to follow-up. On examination, patient had an edematous, nonerythematous right fourth proximal interphalangeal PIP joint. Urgent irrigation, debridement, and exploration of the right hand into the tendon sheath were performed. With his history of syphillis, an RPR was done, which was reactive with a titer of 1 : 64. A confirmatory FTA-ABS test was completed, rendering a positive result. Based on his history of untreated syphilis, dormancy followed by clinical scenario of swelling of the right fourth finger, and a high RPR titer, he was diagnosed with secondary syphilis manifesting as tenosynovitis.

Autor: Felicia Ratnaraj, David Brooks, Mollie Walton, Arun Nagabandi, and Mahmoud Abu Hazeem



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