P772 Gastric syphilis: a case of gastric syphilis developed into neurosyphilis

Background Syphilis caused by the spirochetes Treponema pallidum, which transmitted mainly through sexual contact and blood transmission. The spirochetes spread from the damaged skin to bloodstream, at which point any organ may be affected included bone, central nervous system, and visceral organs-the stomach. Therefore, when treating patients with syphilis, the clinician must rule out the involvement of other organs. Gastric syphilis is a rare presentation of infection with Treponema pallidum, which has no-specific symptoms. Gastric syphilis may occur in any phase of syphilis, predominantly in the secondary (50%), but rarely in the third(6%). There are no standard recommendations specifically address the treatment of gastric syphilis. The general approach is to treat according to the stage of the disease. However, if the clinician does not have experience the disease will be misdiagnosed. Here, we will describe a case of a patient with gastric involvement, whose symptom repeated after conventional treatment. Methods The patent’s history, clinical examination, biology, cerebrospinal fluid,blood nest PCR findings and reatment are reported. We also discuss the profit treatment options. Results we described a case of a patient with the complaint of epigastralgia, pyrosis, and regurgitation. The gastroscopy revealed multiple ulcerative lesions at the antrum, gastric angle and duodenal ampulla, in which suspected cancer. Mucosal biopsy revealed an inflammatory infiltrate with multiple mature plasma cells. Immunohistochemistry and a nested PCR showed the presence of Treponema pallidum in the gastric tissues. But, with conventional treatment, the symptom repeated. Conclusion The patient was diagnosed as having neurosyphilis with gastric syphilis.Her epigastric pain improved on the seventh day of the treatment. Follow-up gastroscopic findings tree months after diagnosis showed improved ulcerative lesions on gastric antrum and duodenal ampulla. The CSF examination was negative. Disclosure No significant relationships.