Picture of the Month—Diagnosis | Infectious Diseases | JAMA Pediatrics | JAMA Network
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Special Feature
February 2007

Picture of the Month—Diagnosis

Author Affiliations


Arch Pediatr Adolesc Med. 2007;161(2):200. doi:10.1001/archpedi.161.2.200

Treponemal and nontreponemal test results confirmed the suspicion of acquired secondary syphilis. On further questioning, the patient disclosed unsafe sexual activity and a history of gonococcal infection 6 months earlier, treated with ceftriaxone and doxycycline. He did not have antibodies to human immunodeficiency virus. He was treated with an intramuscular injection of 2.4 million units of benzathine penicillin. Clinical improvement and a decrease of serologic titers were noted during the follow-up.

Syphilis is a worldwide chronic infectious disease caused by the spirochete Treponema pallidum. Although rates of syphilis infection reached a nadir in 2000, an upward trend in incidence has been recently described in different countries.1,2