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Syphilitic uvula ulcer.

Koko Shibutani1, Nobuyoshi Mori1

  • 1Division of Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan.

Idcases
|September 12, 2024
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Summary
This summary is machine-generated.

A man with HIV experienced a painful uvula ulcer, diagnosed as primary syphilis. Prompt treatment with penicillin rapidly resolved the infection, highlighting the importance of timely diagnosis and treatment.

Keywords:
Sexually transmitted infectionsSyphilis

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Dermatology

Background:

  • Syphilis is a sexually transmitted infection that can manifest with diverse clinical presentations.
  • Human immunodeficiency virus (HIV) infection and syphilis share common transmission routes and can impact disease progression.
  • Primary syphilis often presents with a chancre, but atypical oral lesions can occur.

Observation:

  • A 42-year-old male with HIV and a history of syphilis presented with fever and severe sore throat.
  • Examination revealed an injected throat and a uvula ulcer, with negative PCR for common pharyngeal pathogens and Group A Streptococcus.
  • Rapid plasma reagin (RPR) titer increased to 1:2, indicating active syphilis infection.

Findings:

  • The uvula ulcer was diagnosed as primary syphilis based on clinical presentation and serological findings.
  • The patient received a single intramuscular dose of 2.4 million units of benzylpenicillin.
  • Complete resolution of the uvula ulcer was observed within seven days of treatment.

Implications:

  • This case underscores the importance of considering syphilis in the differential diagnosis of oral ulcers, especially in high-risk individuals.
  • Early diagnosis and treatment of primary syphilis are crucial for preventing complications and transmission.
  • The rapid response to penicillin highlights its efficacy in treating primary syphilis, even in patients with HIV.