83-year-Old Man Married 50 Years Nearly Stumps Doctors with Surprise STI
An 83-year-old man with a 50-year marriage presented a diagnostic challenge to physicians after developing a complex array of symptoms including rash, general illness, facial paralysis, and swelling. Initial investigations revealed abnormalities in his liver and kidney function,further complicating the case.
The man’s medical history included a sexually transmitted infection (STI) decades prior, initially leading doctors to consider a late-stage manifestation of a previously contracted syphilis. However, the presentation didn’t fully align with typical late-stage symptoms. Syphilis progresses through stages: a primary stage marked by a painless sore called a chancre, a secondary stage involving systemic symptoms like rash, fever, and joint pain, a latent stage where the infection is inactive, and a tertiary stage potentially damaging vital organs.
Doctors resolute the patient’s symptoms were most consistent with the secondary stage of syphilis, characterized by widespread infection throughout the body. This stage typically appears within the first year of an untreated primary infection, and rarely beyond four years. While immunosuppressant medication, such as the steroid the patient received for his facial paralysis, can reactivate a latent infection, reactivation usually results in late-stage syphilis, not a secondary outbreak.
This discrepancy raised questions about the source of the current infection. The doctors concluded that the patient’s past STI history couldn’t account for the present illness, suggesting a more recent, and potentially unreported, exposure. The exact timing and origin of the infection remain undetermined.
fortunately, the man responded well to antibiotic treatment and made a full recovery. Public health officials were notified to assist in identifying and informing any recent sexual contacts. The status of the patient’s wife was not detailed in the report.
