Forty cases of acquired oral syphilis and a review of the literature

Schuch, Lauren Frenzel; SILVA, Karine Duarte da; Arruda, José Alcides Almeida de; Etges, Adriana; Gomes, Ana Paula Neutzling; Mesquita, Ricardo Alves; Vasconcelos, Ana Carolina Uchôa; Tarquínio, Sandra Beatriz Chaves

doi:10.1016/j.ijom.2018.10.023

Cited by 36 publications

(87 citation statements)

References 74 publications

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“…Clinically, in primary syphilis, oral lesions are ulcerated and asymptomatic in both HIV‐positive 4 and non‐HIV‐positive patients, 18‐22 as in our case. However, in secondary syphilis, oral lesions have a heterogeneous pattern, including the presence of typical mucous patches or superficial ulcers in both HIV‐positive 4‐6 and non‐HIV‐positive patients, 19,21,23‐26 a clinical presentation observed in the early stage in our patient.…”

Section: Discussionsupporting

confidence: 58%

“…DISCUSSIONThe relevance of this case lies on its unusual presentation in clinical, histopathological, and serological terms, and alerts the clinician about the possibility of syphilis even in the absence of seroconversion. The present case illustrates consideration for syphilis in persistent chronic infiltrates that cannot be otherwise explained.Clinically, in primary syphilis, oral lesions are ulcerated and asymptomatic in both HIV-positive4 and non-HIV-positive patients,[18][19][20][21][22] as in our case. However, in secondary syphilis, oral lesions have a heterogeneous pattern, including the presence of typical mucous patches or superficial ulcers in both HIV-positive 4-6 and non-HIV-positive patients,19,21,[23][24][25][26] a clinical presentation observed in the early stage in our patient.…”

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confidence: 57%

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The challenging diagnosis of overlapping oral primary/secondary syphilis with nonreactive serology

2020

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The prevalence of oral syphilis, known as "the great imitator" because of its diagnostic complexity and varied clinical manifestations, is increasing worldwide, particularly in people living with HIV (PLWH), who could present false-negative serological results. Although some studies have described the variable presentation of oral syphilis in the context of HIV infection, the difficulty in distinguishing between the primary and secondary stages, clinically and histopathologically, underscores the need to describe atypical cases. We report the case of a 28-year-old HIV-positive man presenting with a 3-month history of painless white/red ulcerated lesion on the soft palate. Physical examination revealed an ulcerated lesion with local signs of inflammation. Initial biopsy revealed a nonspecific inflammatory process and immunohistochemistry (IHC) using anti-Treponema pallidum antibodies showed negative results. The results of serological tests for syphilis (Venereal Disease Research Laboratory and fluorescent treponemal antibody-absorption test) were negative on repeated occasions. Nonetheless, polymerase chain reaction (PCR) assay and subsequent IHC for T. pallidum showed positive results, confirming the diagnosis of oral syphilis. This case illustrates that the diagnosis of oral syphilis is challenging in the absence of serological evidence, and specific tests such as PCR and IHC are useful complementary diagnostic tools.

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Section: Discussionsupporting

confidence: 58%

supporting

confidence: 57%

The challenging diagnosis of overlapping oral primary/secondary syphilis with nonreactive serology

2020

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“…The vermillion and mucosa of the lips and the dorsum and lateral border of the tongue are the most common locations. 2,3 Secondary-stage oral lesions are typically painful and multiple, and they may be accompanied by cutaneous eruptions; the duration varies from 4 to 10 weeks. In this stage, the 2 most common oral lesions are enanthem and mucous patches, the latter being the most frequent.…”

Section: Oral Syphilismentioning

confidence: 99%

Oral syphilis

Arruda

Valle

Mesquita

et al. 2021

Journal of the American Academy of Dermatology

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“…Cases of oral syphilis are also well described in the literature. Oral syphilis usually affects men in their 30 s and 40 s. In the secondary stage, the most common locations are the lips and tongue, which can be mistaken for herpes virus infections or aphthous ulcers [ 2 ]. But the particularity of syphilitic oral lesions is that they are, in the majority of cases, painless.…”

Section: Discussionmentioning

confidence: 99%

Pharyngeal abscess complicated by Lemierre’s syndrome: Identification of an atypical germ

Barguil

Alves

Christen

et al. 2021

IDCases

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Introduction Lemierre’s syndrome is a rare but serious complication of an oral infection mostly related to Fusobacterium necrophorum . This condition combines jugular vein thrombosis and septic emboli to the lungs or other organs. Case presentation We report here an original case of a pharyngeal abscess complicated by Lemierre’s syndrome in a young healthy male patient. Samples taken from the pus of the pharyngeal abscess showed the presence of Gardnerella vaginalis associated with Fusobacterium necrophorum . The patient was treated by draining the abscess, antibiotic therapy and preventive anticoagulation for 1 month. The evolution was good with a resolution of the thrombosis. Conclusions This case highlights the need for bacterial identification to adapt antibiotic therapy in Lemierre’s syndrome. It also shows the possibility of extragenital localization of Gardnerella vaginalis in a male patient having oral sex with women. In contrast to sexually transmitted infections such as syphilis and pharyngeal gonococcus, this oral localization of Gardnerella vaginalis has not been described previously in the literature.

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Forty cases of acquired oral syphilis and a review of the literature

Cited by 36 publications

References 74 publications

The challenging diagnosis of overlapping oral primary/secondary syphilis with nonreactive serology

The challenging diagnosis of overlapping oral primary/secondary syphilis with nonreactive serology

Oral syphilis

Pharyngeal abscess complicated by Lemierre’s syndrome: Identification of an atypical germ

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