Challenges diagnosing syphilis in antenatal pacific islanders: A case of secondary syphilis

Cases of syphilis are increasing worldwide. Missed diagnosis of syphilis can have serious consequences, particularly in pregnancy. In areas where yaws, a non-sexually transmitted infection due to Treponema pallidum sub-species pertenue ( T. pertenue ) is endemic, the interpretation of syphilis serology is complex. In Vanuatu, where infection with yaws is prevalent, patients may have positive treponemal serology because of the latter in childhood. We present a case of secondary syphilis with an atypical rash in a post-partum woman in Vanuatu.