Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum . Gastric syphilis is a rare manifestation of the disease, usually developing in secondary syphilis, and can mimic a wide range of gastrointestinal disorders. We present the case of a 65-year-old man who presented with two weeks of epigastric pain, nausea and weight loss. Gastroscopy revealed diffuse erythema and erosions. Histopathology showed a severe active chronic gastritis with a prominent plasma cell infiltrate, and Treponema pallidum organisms were identified on immunohistochemistry. A syphilis diagnosis was confirmed by reactive syphilis serology. In this context an upper eyelid lesion was biopsied, and the histopathology of a previous anal ulcer was revisited, and both specimens showed acute on chronic inflammation with Treponema pallidum organisms again seen on immunohistochemistry. The patient experienced rapid clinical improvement following a course of intramuscular penicillin therapy.
Losic et al. (Sun,) studied this question.