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BACKGROUND The associated infection with Treponema pallidum and human immunodeficiency virus (HIV) was responsible for the return of malignant syphilis. METHODS We report a case of malignant syphilis which revealed a HIV seropositivity. The lesions were typical. Serological features were in accordance with the diagnosis. A treatment with penicillin was prescribed and there was no relapse after five years. CONCLUSIONS The diagnosis of malignant syphilis in a HIV positive patient may be difficult. The course of the disease may be serious and a prolonged treatment with high doses of penicillin is often necessary. The occurrence of the malignant syphilis in HIV positive patients is not fortuitous and seems to be related to an abnormal immunity.
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