Ear Nose Throat J. 2021 Sep;100(5_suppl):538S-539S. doi: 10.1177/0145561319890154.
FIRST PARAGRAPH: There has been a recent reemergence in the development of oral syphilis, a sexually transmitted infection caused by the Treponema pallidum subspecies pallidum spirochaeta bacterium, with oral manifestations dependent on stage at presentation (early: primary, secondary, early latent; late: late latent, tertiary). Oral sex has contributed to the overall increase in disease spread, with the highest incidence in 25- to 29-yearold males (88% of oral cases documented in males, especially in males who have sex with males). Concurrent infections with HIV or other sexually transmitted infections are common. The lips, tongue, and palate are most commonly infected, while tonsils and gingiva may also be affected. Early primary presentation is of a painless, usually solitary ulcer (chancre) which forms about 3 weeks after inoculation (Figure 1). Early secondary presentation is about 3 to 12 weeks after chancre resolution and is the stage most oral syphilis is diagnosed. There are mucous white patches, sometimes multifocal. Condyloma lata is a papillary lesion. Latent syphilis is considered inactive disease, with serologic proof of infection, but without disease symptoms, usually >1 year after secondary syphilis. Tertiary syphilis may develop anywhere up to 15 years after initial infection, showing gumma (granulomatous inflammation) of the palate and/or tongue with atrophic luetic glossitis. Congenital manifestations are rare (screwdriver-shaped incisors and mulberry molars). Treatment involves intramuscular penicillin injections with appropriate counseling and screening for other sexually transmitted diseases.
PubMed ID: 31760793
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