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treponemal gastritis

Thursday 23 February 2012

Like tuberculous gastritis, gastric syphilis was a medical curiosity in the years preceding the AIDS pandemic.

Recently, however, an increasing number of cases has been reported in human immunodeficiency virus (HIV)-infected patients.

When associated with secondary syphilis, syphilitic gastritis is characterized by a prominent mixed inflammatory infiltrate consisting predominantly of plasma cells and with mucosal ulcerations.

Mononuclear vasculitis involving larger vessels in the submucosa and muscularis propria is a consistent feature of syphilitic gastritis and suggests the diagnosis.

Spirochetes may be seen in sections stained with appropriate silver stains (Dieterle, Steiner, or Warthin-Starry).

The infiltrate may be dense enough to cause the swelling of gastric folds, which may also undergo erosion and ulceration, sometimes mimicking the endoscopic appearance of lymphoma or infiltrating carcinoma

See also

- Treponema pallidum