Syphilitic cervical lymphadenopathy: return of an old foe

We present the case of a 38-year-old man who presented to the ENT clinic with cervical lymphadenopathy, oral ulceration, and generalized rash. He was diagnosed with syphilis after serologic testing. After years of decline, the incidence of syphilis is now increasing. It is unusual for patients to present to the otolaryngologist, but the recent marked increase in the incidence of syphilis in the UK is likely to translate into a greater incidence of pathology in the head and neck region. Knowledge of the condition, along with its head and neck manifestations, remains central to the diagnosis of this treatable infection. This article provides a summary of syphilis in the head and neck, for the latest generation of otorhinolaryngologist.