An Adult with Fever and Progressive Ulcerative Lesions: A Case of Malignant Syphilis

Background: Syphilis has recently reemerged as a significant public health con- cern, with rising incidence rates globally. Malignant syphilis is a rare and severe variant of secondary syphilis, often associated with immunocompromised states, particularly HIV in- fection. Methods: Here, we reported a rare case of malignant syphilis in a young man with well-controlled HIV. Case: A 35-year-old man with well-controlled HIV presented with disseminated ulcerated nodules and plaques, accompanied by fever, asthenia, and mild itch- ing. Histopathology of the scapular ulcer revealed a granulomatous infiltrate. Cutaneous leishmaniasis, atypical mycobacteriosis, and T-cell lymphomas were excluded. Serological testing and polymerase chain reaction confirmed a diagnosis of malignant syphilis.