Virginia Via Research Day Book 2026

Medical Resident Research Case Reports

22 AN UNCOMMON ASSOCIATION: EXAMINING EARLY SYPHILLIS WITH PROTEINURIA

Kimaya Council, MD; Eric O'Neal, MD; Balaji Desai, MD; Kimberly Bird, MD Corresponding author: Kimaya.Council@LPNT.net

Sovah Health - Danville, Danville, Virginia

was unremarkable except for an incidental finding of moderate pulmonary hypertension. Comments: Despite early syphilis being treatable, other associated symptoms can arise from this example. A unique condition includes renal involvement, particularly from immune complexes with IgG and C1q predominately. Our patient had hypertensive emergency and had proteinuria at the time of admission. Although his creatinine level was within normal limits, it is likely that he had acute kidney injury due to his very small muscle mass and from his complex clinical presentation. A case study reveals a patient with a similar presentation who had concerns for nephrotic syndrome, which resolved after appropriate treatment for early syphilis. In addition, there was concern for neurosyphilis, which was ruled out due to patient's improvement of symptoms and imaging not revealing any significant findings related to this condition. His symptoms have gradually improved, and the patient was planned for discharge home with no home health needs.

Syphilis should be recognized and treated as early as possible. It can lead to tertiary syphilis if left untreated and can uncommonly be associated with proteinuria and other nephrotic conditions. Diagnosis: Early syphilis, complicated by severe eczema and hypertensive emergency with proteinuria Reference: [1] Chrystman, A., Reddy, A., Yasasvhinie, S., Rai, O., Liu, S. Proteinuria and Palmar Clues: Rediscovering the Renal Face of Syphilis. Cureus 2025 May;17(5); e85031

Context: Syphilis is a curable sexually transmitted disease that has been on the rise since the year 2000, approximately up to 15.6 cases per 100,000 males in the United States. Report of Case: We present a 42-year-old male who initially presented to the hospital for an acute progressive onset of penile swelling and a rash. He described his penile discharge as yellow with associated dysuria, and an 8-pound weight loss, and generalized weakness. His rash was described as different from his usual eczema flares. His sexual history included a female partner 2.5 months prior to admission and one partner last year. Physical examination revealed an African-American male lying in bed, in hypertensive emergency, with a diffuse maculopapular rash in various stages of healing on 4 extremities, including the palms and soles of his hands and feet. His labs were noted for RPR being positive. Additional STD panel studies were negative. Patient received 2.4 MMU of IM penicillin in the Emergency Department, which improved his symptoms. A CT Pan Scan was obtained to further investigate his generalized weakness, which

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