Secondary syphilis, 590 dilemmas resolved

Abstract

Introduction: As reported by the World Health Organization (WHO), untilAugust 2016, 5.6million people were infectedwith syphilis every year. Currently, there is a global increase in the incidence of the disease, which is constant in the last decade. Secondary syphilis is the stage of the disease known as «the great imitator», due to the polymorphism that it shows in its various forms of presentation, which usually makes diagnosis difficult with the aggravating factor of the infectivity that represents this stage of the disease. Objectives: To show the current forms of presentation of the secondary syphilis according to what was observed in the Sexually Transmitted Diseases (STDs) section in a hospital of infectious diseases in the Autonomous City of Buenos Aires (CABA), in light of the increasing number of cases of the disease. To observe the diverse spectrum of presentation and to establish different identifying parameters of the disease which can orient, by its simply presence, to the identification of secondary syphilis. Material and methods: a cross-sectional study of the cases of syphilis diagnosed between March 2014 andMarch2017in the STDsection was carriedout. The patients were evaluated according to age, gender, sexuality and clinical forms of presentation. Results: 1,236cases of early syphilis were diagnosed. Prevalence of secondary syphilis was 48%. 70%were men, 49% of both genders were between 20 and 30 years old. Sixty-eight percent (68%) of the patients reported to be heterosexual. Forty-four percent (44%) had mucosal and cutaneous manifestations, while 20% showed only mucosal manifestations and 47% had peripheral adenopathies. Conclusion: This large cohort, the largest according to the bibliography published to date, shows a sustained incidence of secondary syphilis in patients of a public hospital. It is important to emphasize that in the presence of exanthema, withor without mucosal compromise andadenopathy, secondary syphilis should be considered as part of the differential diagnosis.