Table 1 Clinical features in 27 cases of secondary syphilis with long bones of the limbs involvement [6, 13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]
Parameter | No. (%) of Patients | |
|---|---|---|
Demographic | ||
 Male sex | 21/27 | (78%) |
 Age, median (range), year | 32 | (12–64) |
 HIV infection | 10/27 | (37%) |
Clinical findings | ||
 Bone pain | 27/27 | (100%) |
 Recent history of genital ulcer | 3/27 | (11%) |
 Rash | 14/27 | (52%) |
 Generalised lymphadenopathy | 7/27 | (26%) |
General manifestations | ||
 Fever | 9/27 | (33%) |
 Sweating | 6/27 | (22%) |
 Loss of appetite | 5/27 | (19%) |
 Loss of weight | 8/27 | (30%) |
 Increased bone pain at night | 10/27 | (37%) |
Positive serologic test for syphilis | ||
 Nontreponemal test (Kolmer, VDRL, RPR) | 27/27 | (100%) |
 VDRL titre, median (range)a | 1:32 | (1:8–1:320) |
 RPR titre, median (range)b | 1:128 | (1:16–1:512) |
 FTA-ABS | 10/10 | (100%) |
 MHA-TP/TPHA/TPPA | 14/14 | (100%) |
Sites of affected long bones of the limbs | ||
 Tibia | 25/27 | (93%) |
 Fibula | 11/27 | (41%) |
 Ulna | 8/27 | (30%) |
 Radius | 5/27 | (19%) |
 Humerus | 5/27 | (19%) |
 Femur | 5/27 | (19%) |
Imaging findings | ||
 Abnormal plain x-ray | 13/22 | (59%) |
 Abnormal bone scintigraphy | 20/20 | (100%) |
 Abnormal CT or/and MRI | 4/4 | (100%) |
 Multifocal bone involvement | 22/27 | (81%) |
 Destructive bone lesions | 8/27 | (30%) |
Histologic findings of bone biopsy | ||
 Plasma cell or/and lymphocyte infiltrations | 5/8 | (63%) |
 T. pallidum detectionc | 4/8 | (50%) |
Antibiotic treatment | ||
 Benzathine penicillin G | 12/27 | (44%) |
 Penicillin G | 9/27 | (33%) |
 Procaine penicillin G | 4/27 | (15%) |
 Doxycycline | 2/27 | (7%) |
 Azithromycin | 1/27 | (4%) |
 Cephaloridine | 1/27 | (4%) |
 Nafcillin | 1/27 | (4%) |
 Ceftriaxone | 1/27 | (4%) |