Clinical Case – Secondary Syphilis and Family Dysfunction: The Role of the Family Doctor
Abstract:
Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum, with diverse clinical manifesta tions according to disease stage. Its increasing incidence worldwide reinforces the importance of early diagnosis and comprehensive management, particularly in primary care. We report the case of a 37-year-old married male factory worker from a lower-middle socioeconomic background, with moderate family dysfunction. His past medical history included eosinophilic esophagitis. A rare attender of healthcare services, he presented multiple times to the acute care clinic over a two-week period, initially driven by fear of illness rather than specific symptoms. He later developed non-pruritic erythematous maculopapular lesions on the trunk, sparing the palms and soles. Sexually transmitted infection screening was requested. Two days later, his wife sought medical care due to anxiety and de pressive symptoms following the discovery of her husband’s positive VDRL result. The patient subsequently disclosed unprotected extramarital sexual intercourse and was found to have a painless penile lesion. A diagnosis of secondary syphilis was established, and he was treated with intramuscular benzathine penicillin. Both partners required regu lar follow-up due to significant emotional distress, suicidal ideation, and family disruption, which ultimately led to the initiation of divorce proceedings. This case highlights not only the clinical relevance of recognizing secondary syphilis, but also the essential role of the family physician as the first point of contact in managing the medical, emo tional, and relational consequences of disease, emphasizing the holistic and multifaceted nature of family medicine.
