The Great Spiral Masquerader: A Case of Concurrent Secondary Syphilis and Autoimmune Hepatitis

We describe a unique case of rash and acute hepatitis confounded by the presence of syphilis that created suspicion for syphilitic hepatitis, a rare and often misdiagnosed condition. Investigation concerning the etiology alternatively lead to the diagnosis of 2 concomitant conditions: active autoimmune hepatitis and secondary syphilis. To our knowledge, this is the first description in the literature of the simultaneous occurrence of secondary syphilis and autoimmune hepatitis. This case serves to increase the recognition of the clinical characteristics and diagnostic challenges of syphilitic hepatitis and to discuss the potential role of pathogens in the induction of autoimmunity.