A 38-year-old woman was admitted on 26th August, because of fever of unknown origin. She enjoyed good health until August 16th, 1977 when she suddenly had high fever accompanied by chills. On 20th August, she called on a physician in the outpatient department of KawasakiMunicipal Hospital. Aspirin and antibiotics were given and then fever disappeared. On 23rd, high feverredeveloped. Her past history disclosed no problems. However, her husband confessed he noticed initial induration on his penis after travelling abroad. Physical examination revealed swelling of surface lymphnodes in the inguinales and axillas and hepatomegaly. Laboratory data showed GOT 49 IU, GPT 26 IU, alkalinephosphatase 525 IU, α-GPT 85 IU, HBAg nagative, STS positive and IgM 269 mg/dl. Liver biopsy was perfomed and it showed that the portal duct was infiltrated by round cells with polymorphonuclear leukocytes and in the lobules of liver several scattered foci of degeration and necrosis were observed. The pathological changes stated above was compatible with the liver involvement of early syphilis. The elevation of serum transaminase gradually went down into the normal range with the treatment of erythromycin.