Abstract
Syphilitic hepatitis represents a rare manifestation of treponemal infection. Diagnosis is achieved with the presence of characteristic syphilitic signs and symptoms along with positive serological markers, characteristic elevated liver enzymes, and no other alternative cause of hepatobiliary insult. Here we detail a case of a patient presenting with recently diagnosed secondary syphilis causing abnormal liver enzymes. With the increasing incidence of venereal diseases in the United States, this case highlights the importance of identifying syphilis as a differential diagnosis for acute liver injury.