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116:Oral Syphilis: Presentation Of Two Cases[AAOM2021]
EP36078
Poster Title: 116:Oral Syphilis: Presentation Of Two Cases[AAOM2021]
Submitted on 29 Mar 2021
Author(s): Savvas Titsinides
Affiliations: Medical School, National and Kapodistrian University of Athens, Greece
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 415
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Poster Information
Abstract: Background:

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Its clinical characteristics vary considerably, featuring a natural history of three stages, sometimes making the establishment of the diagnosis a major challenge for the clinician. The aim of this report is a brief presentation of two syphilis cases diagnosed via intra-oral signs and symptoms.

Case summary:

Patient A: A 37 year-old male was referred complaining for a symptomatic vestibular lesion, sore throat and general weakness of 2 months duration. His medical history was insignificant except for smoking. On clinical examination a slight erosion on the left mucobuccal vestibule sensitive on palpation was noticed and a raised maculopapular lesion on the right side of the dorsal surface of the tongue. Combining these two clinical signs in one clinical entity and having the report from the patient that he had recently several ephemeral sexual intercourses we asked, in order to be ruled out, testing for sexually transmitted diseases which resulted in a positive for syphilis. Patient was referred to a Dermatologist and appropriate treatment with im Penicillin G was administered.

Patient B: A 44 year-old male was presented, describing a white lesion that he had incidentally noticed on the left dorsal aspect of the tongue for the last 5 months. Patient reported that he was a homosexual, diagnosed with HIV infection 5 years ago, receiving appropriate anti-viral therapy with regular follow-up. Clinically, a whitish plaque-like lesion was identified on the left side of the tongue. Due to high suspicion of sexually transmitted disease patient was ordered for appropriate serum testing, found to be positive for syphilis. Furthermore, patient was sent back to the HIV Clinic where parenteral injections of Penicillin G were administered.

In both patients repeated serum testing and intra-oral examinations confirmed disease regression and finally definitive treatment.

Conclusions:

Syphilitic lesions can be mistaken for those of other infections and conditions. Oral medicine specialists should be aware and suspect syphilitic lesions in all sexually active patients presenting with a new skin rash, oral or genital lesion so that early diagnosis and appropriate treatment should be initiated timely.
Summary: Syphilis is a sexually transmitted disease caused by Treponema pallidum. Its clinical characteristics vary considerably, featuring a natural history of three stages, sometimes making the establishment of the diagnosis a major challenge for the clinician. The aim of this report is a brief presentation of two syphilis cases diagnosed via intra-oral signs and symptoms.

Ask the author questions about this poster:titsinidess@yahoo.com
References: Smith MH, Vargo RJ, Bilodeau EA, Anderson KM, Trzcinska A, Canterbury CR, Fantasia JE, Rawal YB. Oral Manifestations of Syphilis: a Review of the Clinical and Histopathologic Characteristics of a Reemerging Entity with Report of 19 New Cases. Head Neck Pathol. 2021 Jan 18. doi: 10.1007/s12105-020-01283-4. Epub ahead of print. PMID: 33459991.

Schuch LF, da Silva KD, de Arruda JAA, Etges A, Gomes APN, Mesquita RA, Vasconcelos ACU, Tarquinio SBC. Forty cases of acquired oral syphilis and a review of the literature. Int J Oral Maxillofac Surg. 2019 May;48(5):635-643. doi: 10.1016/j.ijom.2018.10.023. Epub 2018 Nov 17. PMID: 30459066.
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