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Case Reports
. 2025 Mar 1;33(1):130-138.
doi: 10.53854/liim-3301-13. eCollection 2025.

Syphilitic pneumonia: case report and systematic review

Giuseppe Pipitone  1 , Michelle Abbott  1 , Andrea Gizzi  1 , Calogero Buscemi  1 , Federica Guida Marascia  1 , Claudia Imburgia  1 , Giacomo Ciusa  1 , Alba La Sala  2 , Giuseppe Giorgio Mancuso  3 , Domenico Messana  4 , Antonio Cascio  5 , Chiara Iaria  1
Affiliations
Case Reports

Syphilitic pneumonia: case report and systematic review

Giuseppe Pipitone et al. Infez Med. .

Abstract

Syphilitic pneumonia is a rare secondary form of Treponema pallidum infection. In this article, we present a case of syphilitic pneumonia in a patient living with Human Immunodeficiency Virus (HIV) with good immune-virological status. We also performed a systematic review of literature and we found 43 cases of syphilitic pneumonia described since 1886. We added our case report and performed a statistical analysis. Our analysis showed that 40/44 (91%) were males, with a median age of 46 years old (IQR 37-56), 9/28 (32%) were people living with HIV (data not available for 16/44 patients), 17/27 (63%) had syphilitic-related hepatitis during the clinical presentation (data not available for 17/44 patients), and 28/42 (66.6%) of patients had maculopapular rash compatible with secondary forms (data not available for 2/42 patients). Furthermore, 74.4% of patients had nodular lesions on chest X-ray or pulmonary Computed Tomography scan. Given the high rate of nodular pneumonia among patients, clinicians should consider it as a common presentation in syphilitic pneumonia.

Keywords: atypical pneumonia; nodular lesions; pulmonary syphilis; syphilis; syphilitic pneumonia.

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Conflict of interest statement

Conflicts of interest: Authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Pulmonary CT scan on day 2, showing millimetric rounded nodular lesions on both lungs (green arrows).
Figure 2
Figure 2
Pulmonary CT scan performed 3 months after discharge showed a volumetric reduction of the nodular lesions on both lungs.
Figure 3
Figure 3
PRISMA flow chart with study retrieval and selection process.
See this image and copyright information in PMC

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