In the end, his combination of rash, malaise, liver and kidney problems, facial paralysis, and swelling all fit with syphilis. However, syphilis that affects the liver is rare, occurring in less than 10 percent of cases, which made the diagnosis particularly difficult.
Doctors think the infection was likely in the second stage. In the first stage, people just develop a chancre at the site of the infection. The chancre develops usually around a month after an exposure, is painless, and resolves on its own. Then the second stage emerges with the bacterial infection going systemic, usually with rash, malaise, loss of appetite, joint pain, swelling, fevers, and sore throat—similar
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