An 18-year-old woman with heroin and cocaine addiction was admitted to hospital due to fever, malaise, skin lesions and suspected diagnosis of chickenpox.
He had been diagnosed with HIV infection at 17 years of age, had a prostatus performed and a year before he had 522 CD4 lymphocytes without antiretroviral treatment and a negative syphilis serology.
Having been well in the past a week begins with fever and general malaise.
After a few days, painful oral ulcers and erythematous lesions on the palms, soles and rest of the extremities extended to the trunk appeared.
He had a severe impression, had maculopapular lesions, vesicles, ulcerations with crater, oral mucosa involvement and bilateral conjunctivitis with preseptal or septic arthritis in the left side.
Neurological examination was normal.
1.
Blood count was normal.
AST 163 U/L, ALT 73 U/L, alkaline phosphatase 1313 U/L, Gamma discoloration (55.8 transgenic lymphocytes 0.48, copy 211 U/L. CD4 lymphocytes 422 1019.1%),
Syphilis serology was positive with RPR 1/64 and FTA +3.
CSF examination and cultures were normal.
The pathological study of the lesions was compatible with the diagnosis of syphilis.
Treponemas were identified with Warthin Starry stain.
She was treated with Penicillin benzathine, with improvement of the lesions in one week, although after four years residual tricles persist.
