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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin
Adhi Dharmasanti, Prasti
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Immunology & microbiology Public Health

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Secondary Syphilis with Multiple Co-Infections of Human Immunodeficiency Virus (HIV), Tuberculosis (TB), and Oral Candidiasis in a 19-Year-Old Men Who Have Sex with Men (MSM): A Case Report Melin, Uliana Nur; Adhi Dharmasanti, Prasti
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 3 (2024): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.3.2024.225-231

Abstract

Background: Syphilis is an infection of the Treponema pallidum bacteria that often occurs along with conditions such as Human Immunodeficiency Virus (HIV) infection, tuberculosis (TB), and oral candidiasis. A weakened immune system affects the complex interactions between these conditions and the clinical presentation as well as the therapeutic management provided to patients. Case: A 19-year-old male with a history of HIV complained of lesions on the skin and mouth. Anamnesis, physical examination, and serological test results establish the diagnosis of secondary syphilis and pulmonary tuberculosis, characterized by a one-month history of phlegm coughing and weight loss, was confirmed via sputum testing. Additionally, oral candidiasis was identified based on clinical examination. Discussion: The patient exhibited complex complications from secondary syphilis, HIV infection, TB, and oral candidiasis. In cases of syphilis with HIV, the appropriate treatment is three doses of Benzathine Penicillin G. Anti-Tuberculosis Drugs administration for TB was adjusted based on HIV status and therapy response, and antifungal fluconazole for oral candidiasis. Conclusions: This case highlights the importance of proper management and close monitoring of patients with multiple infectious conditions, including treatment of syphilis patients that has  a higher incidence in men who have MSM, HIV, TB, and oral candidiasis. Timely and appropriate therapy strategies are essential to minimize complications and improve clinical outcomes.
Secondary Syphilis and Human Immunodeficiency Virus (HIV) Co-infection in Men Who Have Sex with Men (MSM) with Triple Doses Benzathine Penicillin G Treatment: A Case Report sunarto, olivia awwalin; Suyoso, Sulaksanaswastho; Adhi Dharmasanti, Prasti
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 35 No. 1 (2023): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V35.1.2023.81-87

Abstract

Background: World Health Organization (WHO) reported that there are 6 million new cases of syphilis worldwide per year. The incidence of syphilis in Indonesia has increased over the past few years, particularly among men who have sex with men (MSM). Purpose: To report a case of secondary syphilis with Human Immunodeficiency Virus (HIV) coinfection in MSM, thereby increasing understanding of high-risk sexual behavior among MSM. Case: A 26-year-old man with a chief complaint of rashes on both palms, soles of the feet, and face. The rashes spread with no itching, heat, or pain, which occurred two weeks ago. The patient was diagnosed with HIV in 2019. Physical examination found multiple violaceus macules with clear boundaries, 0.5–1 cm in size, covered with scales. Venereal Disease Research Laboratory (VDRL) serology titer was 1:16 and Treponema Pallidum Haemagglutination Assay (TPHA) was 1:20.480. The recent CD4 count was 440 with an undetectable HIV RNA viral load. Benzathine penicillin G 2.4 million units was given intramuscularly 3 times at 1-week intervals. The patient experienced clinical improvement and decreased VDRL and TPHA titers. Discussion: Syphilis patients with or without HIV would have similar clinical symptoms. However, syphilis patients with HIV tend to have more extensive lesions. The treatment option with three doses of benzathine penicillin G is still very effective in cases of syphilis with HIV. Conclusion: Syphilis has a higher incidence in MSM patients with extensive clinical manifestations of skin lesions. It can be observed in syphilis patients with HIV; therefore, close monitoring is needed.
Co-Authors Melin, Uliana Nur Sunarto, Olivia Awwalin Suyoso, Sulaksanaswastho