Granulome centro-facial révélant une syphilis tertiaire

Chakir, Karima; Benchikhi, H.

doi:10.11604/pamj.2013.15.82.3011

Cited by 3 publications

(6 citation statements)

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“…The evolution is often difficult to predict and it is necessary to look for other prognostic markers such as cytogenetics. 2 We report a case of late diagnosed mid-facial malignant granuloma correlated with the literature review.…”

Section: Introductionmentioning

confidence: 90%

Mediofacial malignant granuloma: a case report and review of the literature

Aliou,

Ibrahima,

Sayon

et al. 2023

JOENTR

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We report a case of malignant midfacial granuloma or idiopathic midfacial granulomatosis in a 50-year-old male farmer with no previous history. He was admitted to the department in an emergency context. The history was reportedly 18 months old. He presented a symptomatology made of nasal obstruction, fever, headache and rhinorrhea with an altered general state. He consulted several health facilities. The evolution was marked by the aggravation of the symptomatology. The examination at admission noted an alteration of the general state. Examination of the ENT sphere revealed ulcerative-necrotic lesions with a destructive nasal origin, with bone sequestration, midface edema, and extension to the sinuses and hard palate. The CT scan revealed bony and cartilaginous lysis, irregular thickening of the nasal pyramid, continuity of the nasal septum, and isodensity of the maxillary, ethmoidal, and left sphenoidal sinus walls without total filling. Deep biopsies were performed under general anesthesia. Histology was consistent with a granulomatous reaction with progressive tissue destruction. Mycobacterium tuberculosis was absent. Medical treatment was initiated. The evolution was marked by the extension of the lesions, malnutrition and the appearance of generalized oedema. The patient died on the 45th day of his hospitalization in a septic shock situation. Conclusion: Mediofacial granulomatosis is a difficult lesion to diagnose and manage. It requires careful histological exploration in order to differentiate it from other mediofacial destructive lesions. The evolution is most often towards extension and lethal complications.

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Section: Introductionmentioning

confidence: 90%

Mediofacial malignant granuloma: a case report and review of the literature

Aliou,

Ibrahima,

Sayon

et al. 2023

JOENTR

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“…В литературе за последние годы описано несколько случаев гуммозных поражений головного и спинного мозга [13][14][15], сифилитической аневризмы аорты [16], третичных сифилидов кожи и слизистых оболочек [8,[17][18][19][20] у больных с сочетанием сифилиса и ВИЧ-инфекции. С другой стороны, случаи третичных поражений кожи и слизистых у пациентов, не инфицированных ВИЧ, также были зарегистрированы в разных странах мира: в России [21,22], США [23,24], Франции [25], Португалии [26][27][28], Болгарии [29], Марокко [30,31], Индии [32], что дало некоторым исследователям повод говорить о возвращении, «ренессансе» третичного сифилиса [21,29]. Среди факторов, способствующих переходу заболевания в третичную стадию, кроме ВИЧ-инфекции современные исследователи указывают также алкоголизм [1,26], употребление наркотиков [33], психические расстройства [3,26], недоступность адекватной медицинской помощи [30], необоснованное обращение к нетрадиционной медицине [25].…”

Section: описание случаяunclassified

“…В литературе за последние 20 лет (1994-2014) мы нашли 14 описаний клинических проявлений третичного активного сифилиса кожи -10 случаев бугоркового сифилида (5 -у мужчин и 5 -у женщин; средний возраст 42,5 года) и 4 -гуммозного (2 -у мужчин и 2 -у женщин; средний возраст 37 лет). Гуммы располагались у 2 больных на лице [27,31], у одной пациентки на голенях [21] и у одного больного на груди и боковых поверхностях туловища [29]. У 3 пациентов наблюдались солитарные гуммы числом 8 [29], 4 [21] и одна [27], и у одного больного -центрофациальная разлитая гуммозная инфильтрация [31].…”

Section: описание случаяunclassified

“…Гуммы располагались у 2 больных на лице [27,31], у одной пациентки на голенях [21] и у одного больного на груди и боковых поверхностях туловища [29]. У 3 пациентов наблюдались солитарные гуммы числом 8 [29], 4 [21] и одна [27], и у одного больного -центрофациальная разлитая гуммозная инфильтрация [31].…”

Section: описание случаяunclassified

“…У одной пациентки отмечалась болезненность гуммозного узла [21]. При самопроизвольном вскрытии узлов выделялась желтоватая серозная или мутная гнойная жидкость [29,31]. Гуммозные язвы имели геометрически правильные округлые очертания, плотные валикообразные края, отвесно спускающиеся ко дну [21,27].…”

Section: описание случаяunclassified

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A case of tertiary syphilis manifested with multiple skin gummas

Krasnoselskikh

Mikheev

Grigorian

et al. 2015

Vestnik dermatologii i venerologii

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The tertiary cutaneous syphilis has become extremely rare as a result of the effective treatment of early syphilis with penicillin and occasional antibiotic therapy for concomitant infections. We report a case of tertiary gummatous syphilis associated with asymptomatic neurosyphilis that was initially misdiagnosed as basal cell carcinoma of the skin. A 67-year-old woman presented with the 18-month history of multiple, firm, bluish-red asymptomatic nodes on the parietal scalp, chin and lateral part of the trunk that had developed without preceding trauma. One node on the trunk had small central ulceration covered with dry yellowish crust. On the left retroauricular area the brownish-purple atrophic scar was observed. Blood tests revealed reactive VDRL, ELISA and TPHA assays. Skin biopsy has showed endarteritis with endothelial swelling and caseating granulomas along with plasmocytic infiltrate in the dermis and subcutaneous tissue. Increased lymphocyte count and the positive VDRL test with cerebrospinal fluid have confirmed the diagnosis of asymptomatic syphilitic meningitis in this patient. The treatment with aqueous penicillin intravenously has lead to resolution of the skin infiltrates and progressive more than 4-fold reduction of follow-up serum VDRL titers. This case is reported as a reminder of the possibility of tertiary syphilis with misleading clinical patterns in patients infected during the epidemics of 1995-2000. We would like to emphasize the necessity to perform timely serological and pathomorphological study to prevent misdiagnosis and mistreatment.

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Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

Jankowska

Adamski

Polańska

et al. 2022

IJERPH

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Tertiary syphilis is a large diagnostic challenge. It is rarely the case that it affects the skin, bone tissue and the eyes at the same time. The presented case shows that extensive symptomatology of syphilis poses a challenge in making a proper diagnosis in patients whose history does not suspect STDs. The study aims to present the case of a young woman hospitalized with a suspected autoimmune disease, diagnosed with symptomatic late syphilis with involvement of the skin, bones and eyes.

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Granulome centro-facial révélant une syphilis tertiaire

Cited by 3 publications

References 0 publications

Mediofacial malignant granuloma: a case report and review of the literature

Mediofacial malignant granuloma: a case report and review of the literature

A case of tertiary syphilis manifested with multiple skin gummas

Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

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