Case 39-2005 -- A 63-Year-Old Woman with a Positive Serologic Test for Syphilis and Persistent Eosinophilia

doi:10.1056/NEJMcpc059036

Volume 353:2697-2705		December 22, 2005		Number 25

Case 39-2005 — A 63-Year-Old Woman with a Positive Serologic Test for Syphilis and Persistent Eosinophilia

Edward T. Ryan, M.D., Donna Felsenstein, M.D., Suzanne L. Aquino, M.D., John A. Branda, M.D., and John G. Morgan, M.B.

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Presentation of Case

Dr. Jennifer Phillips (Internal Medicine): A 63-year-old womanwas seen by infectious-disease specialists at this hospitalbecause of a positive serologic test for syphilis and persistentperipheral-blood eosinophilia.

The patient was a native of Cameroon who had immigrated to theUnited States 11 months before these consultations. Ten daysafter she arrived in the United States, she was seen in theemergency department of this hospital because of headache andchest and abdominal pain. The blood pressure was 177/94 mm Hg;a systolic murmur, grade 3 of 6, was heard at the right uppersternal border. An electrocardiogram revealed a . . . [Full Text of this Article]

Differential Diagnosis

Diagnosis of Syphilis

Staging of Syphilis

Eosinophilia

Filariasis

Dr. Edward T. Ryan's Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis

Source Information

From the Tropical and Geographic Medicine Center (E.T.R.), the Divisions of Infectious Diseases (D.F.) and Cardiology (J.G.M.), Department of Medicine, and the Departments of Radiology (S.L.A.) and Pathology (J.A.B.), Massachusetts General Hospital; and the Departments of Medicine (E.T.R., D.F., J.G.M.), Radiology (S.L.A.), and Pathology (J.A.B.), Harvard Medical School.