Oral manifestations of syphilis. Clinical Case.
Abstract Introduction: Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Oral manifestations of syphilis are not frequent but may occur in all stages simulating other diseases, delaying diagnosis and treatment. We describe the case of a patient with oral lesions as a manifestation of secondary syphilis. Discussion: oral manifestations of syphilis may mimic other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Although oral lesions may manifest at all stages, are mainly associated with secondary syphilis. The diagnosis is usually made through serologic tests, however that suspicion needs to be maintained by the clinical and histologic findings. Conclusion: Given the increasing incidence of syphilis, it remains a public health problem worldwide and should be considered in the differential diagnosis of oral lesions in sexually active patients.
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Bjeki? M, Markovi? M, Sipeti? S. Clinical manifestations of primary syphilis in homosexual men. Braz J Infect Dis. 2012;16(4):387-9.
Carbone PN, Capra GG, Nelson BL. Oral Secondary Syphilis. Head Neck Pathol. 2016;10:206–8.
Carlesimo M, Palese E, Mari E, Feliziani G, La Pietra M, De Marco G, et al. Isolated oral erosions: an unusual manifestation of secondary syphilis. Dermatol Online J. 2008;14(2):23.
Castañeda Curto N, Obeso Agüera S, Morales Angulo C. Patología orofaríngea secundaria a contacto orogenital. Rev Soc Otorrinolaringol Castilla León Cantab La Rioja. [Internet] 2014 [citado el 27 de junio de 2017]; 5:85-7. Disponible en: http://gredos.usal.es/jspui/handle/10366/124038.
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance [Internet] 2013. Atlanta: U.S. Department of Health and Human Services; 2014. Disponible en https://www.cdc.gov/std/stats13/surv2013-print.pdf [Citado el 27 de junio de 2017].
Clinicians' Alertness. Case Rep Dent. 2016;2016:6295920.
de Paulo LF, Servato JP, Oliveira MT, Durighetto AF, Zanetta-Barbosa D. Oral Manifestations of Secondary Syphilis. Int J Infect Dis. 2015;35:40-2.
Drago F, Ciccarese G, Cogorno L, Tomasini CF, Cozzani EC, Riva SF et al. Primary syphilis of the oropharynx: an unusual location of a chancre. Int J STD AIDS. 2015;26(9):679-81.
Dybeck Udd S, Lund B. Oral Syphilis: A Reemerging Infection Prompting
Fernández-López C, Morales-Angulo C. Lesiones otorrinolaringológicas secundarias al sexo oral. Acta Otorrinolaringol Esp. 2017;68(3):169-80.
Fregnani ER, Pérez-de-Oliveira ME, Parahyba CJ, Perez DE. Primary syphilis: An uncommon manifestation in the oral cavity. J Formos Med Assoc. 2017;116(4):326-7.
Gedela K, Boag F. Syphilic tonsillitis in primary care: a case report. Brit J Gen Pract. 2012:219-20.
Hamlyn E, Marriott D, Gallagher RM. Secondary syphilis presenting as tonsillitis in three patients. J Laryngol Otol. 2006;120:602-4.
Hertel M, Matter D, Schmidt-Westhausen AM, Bornstein MM. Oral syphilis: a series of 5 cases. J Oral Maxillofac Surg. 2014;72(2):338-45.
Hicks CB, Sparling PF. Pathogenesis, clinical manifestations, and treatment of early syphilis. 2013. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. [Citado el 27 Jun. 2017].
Ikenberg K, Springer E, Brauninger W, Kerl K, Mihic D, Schmid S, et al. Oropharyngeal lesions and cervical lymphadenopathy: syphilis is a differential diagnosis that is still relevant. J Clin Pathol. 2010;63:731-6.
Larsen SA, Steiner BM, Rudolf AH. Laboratory diagnosis and test for syphilis. Clin Microbiol Rev. 1995;8:1-21.
Larsen SA. La sífilis en el momento actual. En: Picazo JJ, Bouza E (eds). Infección 1999. Servisistem 2000 SL, Bilbao, 1999, pp 177-216.
Leuci S, Martina S, Adamo D, Ruoppo E, Santarelli A, Sorrentino R, et al. Oral Syphilis: a retrospective analysis of 12 cases and a review of the literature. Oral Dis. 2013;19(8):738-46.
Ortega KL, Rezende NP, Watanuki F, Araujo NS, Magalhaes MH. Secondary syphilis in an HIV positive patient. Med Oral 2004;9:33-8.
Seibt CE, Munerato MC. Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study. Braz J Infect Dis. 2016;20(4):393-8.
Siqueira CS, Saturno JL, de Sousa SC, da Silveira FR. Diagnostic approaches in unsuspected oral lesions of syphilis. Int J Oral Maxillofac Surg 2014;43(12):1436–40.
Strieder LR, León JE, Carvalho YR, Kaminagakura E. Oral syphilis: report of three cases and characterization of the inflammatory cells. Ann Diagn Pathol. 2015;19:76-80.
Tucker JD, Yin YP, Wang B, Chen XS, Cohen MS. An expanding syphilis epidemic in China: epidemiology, behavioural risk and control strategies with a focus on low-tier female sex workersand men who have sex with men. Sex Transm Infect. 2011;87(Suppl 2):16-8.
Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines. MMWR. 2010. Sex Transm Dis. 2012; 39(12):954-8.
Yang CJ, Chang SY, Wu BR, Yang S4, Liu WC, Wu PY, et al. Unexpectedly high prevalence of Treponema pallidum infection in the oral cavity of human immunodeficiency virus-infected patients with early syphilis who had engaged in unprotected sex practices. Clin Microbiol Infect. 2015;21(8):787.e1-7.
Carbone PN, Capra GG, Nelson BL. Oral Secondary Syphilis. Head Neck Pathol. 2016;10:206–8.
Carlesimo M, Palese E, Mari E, Feliziani G, La Pietra M, De Marco G, et al. Isolated oral erosions: an unusual manifestation of secondary syphilis. Dermatol Online J. 2008;14(2):23.
Castañeda Curto N, Obeso Agüera S, Morales Angulo C. Patología orofaríngea secundaria a contacto orogenital. Rev Soc Otorrinolaringol Castilla León Cantab La Rioja. [Internet] 2014 [citado el 27 de junio de 2017]; 5:85-7. Disponible en: http://gredos.usal.es/jspui/handle/10366/124038.
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance [Internet] 2013. Atlanta: U.S. Department of Health and Human Services; 2014. Disponible en https://www.cdc.gov/std/stats13/surv2013-print.pdf [Citado el 27 de junio de 2017].
Clinicians' Alertness. Case Rep Dent. 2016;2016:6295920.
de Paulo LF, Servato JP, Oliveira MT, Durighetto AF, Zanetta-Barbosa D. Oral Manifestations of Secondary Syphilis. Int J Infect Dis. 2015;35:40-2.
Drago F, Ciccarese G, Cogorno L, Tomasini CF, Cozzani EC, Riva SF et al. Primary syphilis of the oropharynx: an unusual location of a chancre. Int J STD AIDS. 2015;26(9):679-81.
Dybeck Udd S, Lund B. Oral Syphilis: A Reemerging Infection Prompting
Fernández-López C, Morales-Angulo C. Lesiones otorrinolaringológicas secundarias al sexo oral. Acta Otorrinolaringol Esp. 2017;68(3):169-80.
Fregnani ER, Pérez-de-Oliveira ME, Parahyba CJ, Perez DE. Primary syphilis: An uncommon manifestation in the oral cavity. J Formos Med Assoc. 2017;116(4):326-7.
Gedela K, Boag F. Syphilic tonsillitis in primary care: a case report. Brit J Gen Pract. 2012:219-20.
Hamlyn E, Marriott D, Gallagher RM. Secondary syphilis presenting as tonsillitis in three patients. J Laryngol Otol. 2006;120:602-4.
Hertel M, Matter D, Schmidt-Westhausen AM, Bornstein MM. Oral syphilis: a series of 5 cases. J Oral Maxillofac Surg. 2014;72(2):338-45.
Hicks CB, Sparling PF. Pathogenesis, clinical manifestations, and treatment of early syphilis. 2013. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. [Citado el 27 Jun. 2017].
Ikenberg K, Springer E, Brauninger W, Kerl K, Mihic D, Schmid S, et al. Oropharyngeal lesions and cervical lymphadenopathy: syphilis is a differential diagnosis that is still relevant. J Clin Pathol. 2010;63:731-6.
Larsen SA, Steiner BM, Rudolf AH. Laboratory diagnosis and test for syphilis. Clin Microbiol Rev. 1995;8:1-21.
Larsen SA. La sífilis en el momento actual. En: Picazo JJ, Bouza E (eds). Infección 1999. Servisistem 2000 SL, Bilbao, 1999, pp 177-216.
Leuci S, Martina S, Adamo D, Ruoppo E, Santarelli A, Sorrentino R, et al. Oral Syphilis: a retrospective analysis of 12 cases and a review of the literature. Oral Dis. 2013;19(8):738-46.
Ortega KL, Rezende NP, Watanuki F, Araujo NS, Magalhaes MH. Secondary syphilis in an HIV positive patient. Med Oral 2004;9:33-8.
Seibt CE, Munerato MC. Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study. Braz J Infect Dis. 2016;20(4):393-8.
Siqueira CS, Saturno JL, de Sousa SC, da Silveira FR. Diagnostic approaches in unsuspected oral lesions of syphilis. Int J Oral Maxillofac Surg 2014;43(12):1436–40.
Strieder LR, León JE, Carvalho YR, Kaminagakura E. Oral syphilis: report of three cases and characterization of the inflammatory cells. Ann Diagn Pathol. 2015;19:76-80.
Tucker JD, Yin YP, Wang B, Chen XS, Cohen MS. An expanding syphilis epidemic in China: epidemiology, behavioural risk and control strategies with a focus on low-tier female sex workersand men who have sex with men. Sex Transm Infect. 2011;87(Suppl 2):16-8.
Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines. MMWR. 2010. Sex Transm Dis. 2012; 39(12):954-8.
Yang CJ, Chang SY, Wu BR, Yang S4, Liu WC, Wu PY, et al. Unexpectedly high prevalence of Treponema pallidum infection in the oral cavity of human immunodeficiency virus-infected patients with early syphilis who had engaged in unprotected sex practices. Clin Microbiol Infect. 2015;21(8):787.e1-7.
Navazo-Eguía, A. I., Rioja-Peñaranda, E., Echevarria-Iturbe, C., Terán-Muñoz, D., Cordero-Civantos, C., & Ibañez-Muñoz, C. (2017). Oral manifestations of syphilis. Clinical Case. Revista ORL, 8(4), 253–257. https://doi.org/10.14201/orl.16751
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