A Case Report of Syphilitic Hepatitis

A 49-year-old woman presented to the emergency department with acute right upper quadrant pain. Laboratory results were consistent with cholestatic liver injury. Potential common causes—such as obstructive, viral, and autoimmune conditions—were excluded. She began developing systemic symptoms, including rash, vision changes, and headaches. The patient was subsequently found to have secondary syphilis with neurosyphilis and syphilitic hepatitis. Although syphilitic hepatitis is a rare presentation of the disease, syphilis should be considered as a possible cause of transaminitis with a cholestatic pattern of liver injury.