ABSTRACT
Syphilis, caused by Treponema pallidum subsp. pallidum, remains a global health challenge, with a significant burden of new cases annually. The disease disproportionately affects men who have sex with men (MSMs) and endemic, low-income regions. While secondary syphilis typically manifests with a polymorphic rash, individuals with human immunodeficiency virus (HIV) coinfection may present with varied signs and symptoms. Here, we report a case of a 21-year-old male student with painful target lesions on his genitalia, deviating from the typical syphilis presentation. He was found to have concurrent molluscum contagiosum and HIV-1 infection. Serologic testing confirmed syphilis and anti-HIV-1 antibodies. Prompt initiation of antiretroviral therapy and benzathine penicillin G led to symptom resolution. This case highlights the importance of recognizing atypical painful target lesions as a potential manifestation of syphilis, especially in patients with HIV coinfection, to ensure timely diagnosis and treatment.
ABSTRACT
Mycetoma is a chronic granulomatous infectious disease with a triad of subcutaneous swelling, discharging sinuses and the presence of granules. The infection may occur following minor trauma or penetrating thorn injury. We report a case of a man in his 40s with a history of thorn prick 9 years ago, followed by the formation of painless discharging sinuses on the right foot for the past 2 years. Clinical, local epidemiological, histopathological examination and Gram stain confirmed the diagnosis of actinomycetoma. Prior to initiating the Welsh regimen, a pretreatment assessment of the patient's auditory function was conducted through pure tone audiometry, indicating the existence of pre-existing high-frequency bilateral sensorineural hearing loss. The patient was treated with linezolid as an alternative to amikacin, at a dosage of 600 mg two times per day, leading to complete resolution within 3 weeks. This underscores linezolid's efficacy as a safe and cost-effective alternative for actinomycetoma, without causing ototoxic side effects.
