Late syphilis in a cardiac transplant patient

Patients undergoing cardiac transplantation are routinely screened for prior exposure to Treponema pallidum, the bacterium implicated in syphilis. Although acute syphilis typically presents with a painless genital chancre, chronic syphilis can manifest in protean forms and linger undiagnosed. Left untreated, syphilis can cause multi-system disease, particularly irreversible neurologic damage. We describe a case of cutaneous secondary syphilis, neurosyphilis and luetic hepatitis in a cardiac transplant patient.