ArticleInfection and drug resistance2025
Otosyphilis and Malignant Syphilis in a Human Immunodeficiency Virus-Infected Patient: A Case of Bilateral Hearing Loss with Complete Recovery Following Ceftriaxone Therapy - Case Report.
Article in Infection and drug resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Syphilis is characterized by diverse manifestations, including rare complications such as otosyphilis and malignant syphilis, particularly in immunocompromised individuals. Case Presentation: This study reported a case of a 40-year-old Human Immunodeficiency Virus (HIV)-positive male with bilateral sensorineural hearing loss (SNHL) and disseminated ulceronodular skin lesions. Serological testing confirmed active Treatment and Outcome: The patient was treated with intramuscular ceftriaxone 2 grams daily for 14 days as an alternative to penicillin due to accessibility constraints and preference. This led to complete resolution of hearing loss, regression of cutaneous lesions, and a significant clinical serological response, including VDRL seroconversion at 6 months. The treatment did not produce Jarisch-Herxheimer reaction, showing good tolerance and supporting ceftriaxone effectiveness as an alternative therapy in HIV-associated syphilis. Conclusion: This case study underscores the importance of early recognition and treatment of otosyphilis and malignant syphilis in HIV-infected individuals. Ceftriaxone may serve as an effective alternative regimen to penicillin, achieving both clinical and serological recovery. Moreover, routine screening for otologic symptoms in patient with syphilis is critical to prevent irreversible complications. The limitations include the absence of histopathology and CSF analysis conducted after therapy initiation.
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