Manifestação Primária de Sífilis em Cavidade Oral

Abstract

A sífilis é uma infecção sexualmente transmissível (IST), causada pela bactéria espiroqueta Treponema pallidum (TP). A doença pode manifestar-se de diversas formas clínicas quando adquirida (primária, secundária e terciária), e também pode ser congênita. Todas as formas de sífilis podem apresentar manifestações bucais, embora na cavidade oral as lesões sifilíticas sejam incomuns. Atualmente, tem sido observado um aumento na incidência de sífilis entre adultos jovens, especialmente entre os HIV positivos. O objetivo desse trabalho é relatar um caso de sífilis com manifestação oral em um homem imunocompetente, de 26 anos de idade.

Clinical manifestations of syphilis in the oral cavity — a review

“…It was observed that, among the 15 papers, 11 highlight the increase in cases of syphilis in Brazil in the last five years, warning about Source: Prepared by the authors (2022). the importance of preventing this disease by bringing knowledge to society and promoting actions to guarantee the improvement of the surveillance system in health (1,2,4,(10)(11)(12)(13)(14)(15)(16)(17) .…”

“…According to the literature, the diagnosis of primary syphilis has sometimes been made based on the local lesion characteristics, considering that the initial lesions occur at the local where Treponema pallidum has penetrated. In this perspective, Seibt et al (2) and Soerger et al (4) inform that, in the exact place where this microorganism has penetrated, there is formation of hard chancre and, associated with this, systematically, a possible reactive lymphadenomegaly. Santos et al (15) , Souza (18) and Souza et al (11) corroborate this information by saying that, in this stage, there are oral manifestations which shows chancre, becoming visible for a certain period of time, develops as a nonspecific hardened papular lesion and evolves as a painless central ulcer with well-defined margins, characterized by a wet and clean base.…”

“…Santos et al (15) , Souza (18) and Souza et al (11) corroborate this information by saying that, in this stage, there are oral manifestations which shows chancre, becoming visible for a certain period of time, develops as a nonspecific hardened papular lesion and evolves as a painless central ulcer with well-defined margins, characterized by a wet and clean base. In that regard, Seibt et al (2) and Soerger et al (4) point out that the infection mainly affects the tongue, soft palate, hard palate, lips, labial commissures, and buccal mucosa.…”

“…Still about the primary phase of syphilis, when the lesion occurs in the most superficial layers of the mucosa, Pereira et al (10) , Batista et al (1) , Matias et al (17) and De Souza et al (11) add that the presence of chancre can cause swelling of adjacent tissues, which can lead to asymmetry and local discomfort. In addition, depending on the location, these lesions can ulcerate, form pseudomembranes, detachable plaques and even exudation, due to local inflammation, associated with painful symptoms and infarcted submandibular and cervical lymph nodes (1,2,4,(10)(11)(12)(13)(14)(15)(16)(17)(18) . Additionally, Binda et al (19) bring to light that, when the lesion is not treated, the infectious microorganism spreads, the lesion regresses and, thus, initiates secondary syphilis.…”

“…The tertiary syphilis -which happens after a latency moment and can last between 1 and 30 years -is the most critical syphilis stage, triggering cardiovascular and neurological disorders, which can lead to death (4) . At this stage, there is granulomatous inflammation and diffuse interstitial glossitis into the oral cavity mucosa, resulting in a scenario that contributes to the presence of leukoplakias and carcinomas (5) .…”