CYTOLOGIC DIAGNOSIS OF SYPHILITIC PLEURITIS - A CASE-REPORT

We report on a case of a 68-yr-old man with secondary syphilis diagnos ed by biopsy of skin lesions, who concomitantly suffered from left low er lobe pneumonia with associated pleuritis. Cytologic examination of the pleural fluid was diagnostic of syphilis, not only by the characte ristic cytomorphology but also by demonstration of spirochetes by the May-Grunwald-Giemsa (MGG) and Steiner staining methods. This suggests that the pneumonia was also syphilitic. The patient was seropositive f or HIV-I, but this probably did not contribute to the thoracic manifes tations of syphilis, as there was no evidence of immunodeficiency by t he CD4/CD8 T lymphocyte count. This is the second reported demonstrati on of Treponema pallidum in a pleural fluid, and the first diagnosed b y cytopathologic examination. Diagn. Cytopathol. 16:35-38, 1997. (C) 1 997 Wiley-Liss, Inc.