RT Book, Section
A1 Chumley, Heidi S.
A1 Usatine, Richard P.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164349559
T1 Syphilis
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK accessmedicine.mhmedical.com/content.aspx?aid=1164349559
RD 2024/04/16
AB A  39-year-old  woman  presents  with  a  nonhealing  ulcer  over  her  upper  lip  for  1  week  and  a  new-onset  rash  on  her  trunk  (Figures  225-1  and  225-2).  The  ulcer  on  her  upper  lip  was  misdiagnosed  as  herpes  simplex  by  another  physician.  Sexual  history  revealed  that  the  patient  had  oral  sex  with  a  boyfriend  who  had  a  lesion  on  his  penis  and  she  suspected  that  he  had  been  having  sex  with  other  women.  The  examining  physician  recognized  the  nonpainful  ulcer  and  rash  as  a  combination  of  primary  and  secondary  (P&S)  syphilis.  An  RPR  (rapid  plasma  reagin)  was  drawn  and  the  patient  was  treated  immediately  with  IM  benzathine  penicillin.  The  RPR  came  back  as  1:128  and  the  ulcer  was  healed  within  1  week.