Concurrent benign tertiary syphilis and asymptomatic neurosyphilis in an immunocompetent patient

syphilis is known to be "the great imitator": since the patient's history is often deceiving and the spectrum of clinical signs and symptoms is extremely broad, diagnosis may be particularly challenging1,2 . Tertiary syphilis is rarely seen nowadays but it should be taken into account when dealing with granulomatous disorders of unclear nature. Indeed, up to 25% of the patients with untreated primary syphilis develop symptoms of tertiary syphilis, usually occurring three to five years after primary infection and involving several organs, mainly skin, heart and central nervous system.