REINFECTION IN EARLY SYPHILIS THAT HAD BEEN TREATED WITH PENICILLIN (PING-PONG SYPHILIS)

Abstract

The following case report is presented as a striking example of reinfection in syphilis that had been treated with penicillin. H. H., a Negro aged 25 years, was first seen by us on April 20, 1949, with a history of a penile sore of one week's duration. He named E. W., a patient found to be under treatment for early syphilis in our clinic, as his only contact; he denied that he had a wife. There was no history of previous lesions or treatment of syphilis. A serologic test had given negative reactions in 1946. Examination revealed an indurated papular lesion surrounding the external urinary meatus and firm, nontender enlarged inguinal lymph nodes bilaterally. Physical examination was otherwise noncontributory. Dark field examination of the lesion was positive for Treponema pallidum; the Wassermann reaction was 4 +; the Kline reaction was 4 + in a quantitative dilution of 1:10 and 3 + in a