Syphilitic Gastritis in an HIV‐infected Individual

We report the first known case of syphilitic gastritis in an HIV‐infected person. The presentation of nonspecific abdominal pain and weight loss in a 48‐yr‐old former intravenous drug user previously treated for asymptomatic syphilis led to a barium swallow which demonstrated linitis plastica. Upper endoscopy reinforced a suspicion of carcinoma, but biopsy made the diagnosis of syphilis by silver staining. Further testing revealed a positive serology for syphilis as well as HIV infection with a depressed CD‐4 lymphocyte count. Treatment with parenteral penicillin led to a rapid resolution of symptoms. This case represents a rare complication of late syphilis, and is another example of the unusual manifestations of syphilis seen in the HIV‐infected population.