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To the Editor.—
In their article "Hepatitis and Bone Destruction as Uncommon Manifestations of Early Syphilis: Report of a Case" (Archives 112:1451-1454,1976), Drs Longstreth, Hoke, and McElroy reported uncommon manifestations of early syphilis with hepatitis and bone destruction. As they mentioned, many cases of this type presumably go unrecognized.At the end of the primary stage, most of the treponemas leave the blood stream and invade the tissues. This intrusion of Treponema pallidum into the tissues of the body leads to the development of the generalized lesions that are called secondary syphilis. In the secondary eruptions on skin and mucous membranes, T pallidum can be demonstrated in very great numbers. Probably all tissues of the body are invaded but not all react by demonstrable changes.The patient often complains of the following commonly named constitutional symptoms of a rather nonspecific character: general tiredness, headache, low grade fever, pains of joints
Lomholt G. Bone Involvement in Early Syphilis. Arch Dermatol. 1977;113(9):1300-1301. doi:10.1001/archderm.1977.01640090148044