Ariane Haagsma - Academia.edu (original) (raw)

Papers by Ariane Haagsma

Background: Syphilis is a chronic infectious disease that is currently reemerging in Brazil, wher... more Background: Syphilis is a chronic infectious disease that is currently reemerging in Brazil, where 227,663 cases of acquired syphilis have been notified at the Brazilian Notifiable Grievance Information System (Sinan), from 2010 to June of 2016. It usually appears to pathologists in skin or genital specimens, but the infection may affect other sites that are not usually studied by histology. Design: We present three cases of non-cutaneous syphilis lacking clinical suspicion of the disease, from a Brazilian university hospital. Case 1: a 26-year-old male with submental lymphadenomegaly measuring 3,0 cm. The biopsy of the lymph node showed follicular lymphoid hyperplasia with plasmocitosis. The patient was submitted to the Rapid Plasma Reagin test (RPR test), reactive at 1:32. Case 2: a 48-year-old female exhibiting a crusty, bleeding to the touch, growth of 2,5 cm on her lower lip. The biopsy showed chronic lymphoplasmacytic inflammation with histiocytic granulomas, combined with vascular proliferation. Her RPR test was reactive at 1:64. Case 3: a 63-yearold female with weight loss and hepatosplenomegaly. Liver biopsy showed chronic granulomatous inflammatory process with a central necrosis. Her RPR was reactive at 1:32. All three patients were submitted to the Fluorescente Treponemal Antibody Absorption test (FTA-ABS test), which resulted reactive. Results: The three patients had a positive serology for syphilis. In case 1, the histological findings of lymphoid hyperplasia and plasmocitosis were compatible with secondary syphilis. In case 2 and 3, the histological findings of granulomatous and fibrous lesions with a central necrosis were compatible with lesions of tertiary syphilis, also known as gumma. Conclusions: Pathological diagnosis of syphilis may be challenging without sufficient clinical information or suspicion, and may happen in association with another diagnose. In the light of the reemergence of the disease, it's important for a pathologist to be able to identify these nonspecific features and relate them to a possible syphilis infection.

Background: Syphilis is a chronic infectious disease that is currently reemerging in Brazil, wher... more Background: Syphilis is a chronic infectious disease that is currently reemerging in Brazil, where 227,663 cases of acquired syphilis have been notified at the Brazilian Notifiable Grievance Information System (Sinan), from 2010 to June of 2016. It usually appears to pathologists in skin or genital specimens, but the infection may affect other sites that are not usually studied by histology. Design: We present three cases of non-cutaneous syphilis lacking clinical suspicion of the disease, from a Brazilian university hospital. Case 1: a 26-year-old male with submental lymphadenomegaly measuring 3,0 cm. The biopsy of the lymph node showed follicular lymphoid hyperplasia with plasmocitosis. The patient was submitted to the Rapid Plasma Reagin test (RPR test), reactive at 1:32. Case 2: a 48-year-old female exhibiting a crusty, bleeding to the touch, growth of 2,5 cm on her lower lip. The biopsy showed chronic lymphoplasmacytic inflammation with histiocytic granulomas, combined with vascular proliferation. Her RPR test was reactive at 1:64. Case 3: a 63-yearold female with weight loss and hepatosplenomegaly. Liver biopsy showed chronic granulomatous inflammatory process with a central necrosis. Her RPR was reactive at 1:32. All three patients were submitted to the Fluorescente Treponemal Antibody Absorption test (FTA-ABS test), which resulted reactive. Results: The three patients had a positive serology for syphilis. In case 1, the histological findings of lymphoid hyperplasia and plasmocitosis were compatible with secondary syphilis. In case 2 and 3, the histological findings of granulomatous and fibrous lesions with a central necrosis were compatible with lesions of tertiary syphilis, also known as gumma. Conclusions: Pathological diagnosis of syphilis may be challenging without sufficient clinical information or suspicion, and may happen in association with another diagnose. In the light of the reemergence of the disease, it's important for a pathologist to be able to identify these nonspecific features and relate them to a possible syphilis infection.