Secondary syphilis of the tonsil

An 18-year-old man with an ulceration of his right tonsil and cervical lymphadenopathy was examined. The patient also had a papular eruption in his face, chest, abdomen, and upper extremities. There were no signs of genital involvement. Routine serological tests for syphilis were reactive and histological findings of a cervical lymph node biopsy were characteristic for syphilitic lymphadenitis. Spirochetes were also identified in the tissue sections. A diagnosis of secondary syphilis of the tonsil with cervical syphilitic lymphadenitis was made. In recent years, the number of new cases of syphilis has increased in Japan. Since the oral cavity is the most common extragenital site of syphilis, clinicians should bear in mind that oral lesions from an unknown cause might possibly be syphilitic.