Because of its size, activity and vascularity, one would expect the liver to be infected frequently with Spirochaeta pallita during the initial stage of spirochetemia. While postmortem statistics (Symmers1 and McNeil2) show that this is true, only a few cases of early involvement are recognized clinically. The clinical cases of syphilitic hepatitis are divided into two groups: first, a mild hepatitis; second, a severe hepatitis or icterus gravis. The incidence of the mild type, according to Wile,3 is recorded in 0.5 per cent of all cases. Stokes4 quoted Werner's incidence at 0.37 per cent and Reimer's at 3 per cent, while Stokes has seen only one case of undoubted mild hepatitis in a survey of 300 cases of early syphilis.
The second type of hepatitis, the severe form, is a complication of syphilis that is seen more rarely. Most authors could report only one case, although
ELLIOTT JA, TODD LC. HEPATITIS OF EARLY SYPHILIS: BLOOD BILIRUBIN DETERMINATIONS AS A POSSIBLE AID IN DIAGNOSIS AND AS A GUIDE TO TREATMENT REPORT OF A CASE. Arch Derm Syphilol. 1928;17(3):299–308. doi:10.1001/archderm.1928.02380090008002
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