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Oral syphilis - the great imitator: a series of six cases
Brian Maloney1, Claire M Healy2
1Division of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Dublin Dental University Hospital, School of Dental Science, Trinity College Dublin, Dublin 2, Ireland.
Abstract:
Syphilis is an infectious disease which can present with multitudinous mucocutaneous manifestations. Often referred to as the 'great mimicker', syphilis can present with non-specific symptoms and has a tropism for various organ systems. The oral cavity has been identified as a site commonly affected in the early stages of syphilis infection. Identification of the diverse presentations seen across the different stages of syphilis infection can assist in early diagnosis and treatment for this cohort of patients. Despite accurate diagnostic tools and the susceptibility of the infection to standard antimicrobial therapy, syphilis infections continue to rise worldwide.We present the clinical features and management of six cases of oral syphilis who presented to our unit. One case presented in 2008, but the other five cases presented between 2016 and 2023, reflecting the increasing incidence of syphilis infection. Five cases presented in the secondary stage of the infection while one presented with a primary infection in the form of a single chancre.The documented cases demonstrate the non-specific and variable clinical features of oral syphilis and highlight the importance of awareness in the dental profession of these manifestations. Dentists have an important role to play in recognising the disease and arranging appropriate testing for early intervention. This will not only reduce the incidence of the devastating consequences of tertiary infections but will also result in reduced spread of the disease.
Insights
Oral syphilis, a rising infectious disease, presents varied symptoms. Early recognition by dentists is crucial for timely treatment and preventing further spread.
Area of Science:
- Infectious Diseases
- Oral Medicine
- Dermatology
Background:
- Syphilis, a sexually transmitted infection, exhibits diverse mucocutaneous manifestations and can affect multiple organ systems.
- The oral cavity is a common site for early syphilis, often presenting with non-specific symptoms, making diagnosis challenging.
- Global syphilis incidence is increasing despite available diagnostic tools and effective antimicrobial treatments.
Purpose of the Study:
- To present the clinical features and management of six oral syphilis cases.
- To highlight the importance of dental professionals' awareness of oral syphilis manifestations for early diagnosis.
- To underscore the role of dentists in identifying oral syphilis and facilitating prompt intervention.
Main Methods:
- Retrospective case series analysis of six patients diagnosed with oral syphilis.
- Review of clinical presentations, stages of infection, and management strategies.
- Analysis of case distribution over time to reflect incidence trends.
Main Results:
- Six cases of oral syphilis were managed, with five presenting between 2016 and 2023, indicating rising incidence.
- Five cases exhibited secondary syphilis, and one presented with primary syphilis (a single chancre).
- The cases demonstrated the variable and non-specific clinical features of oral syphilis.
Conclusions:
- Oral syphilis presents with diverse and often non-specific clinical features, necessitating heightened awareness.
- Dental professionals play a critical role in the early detection of oral syphilis through vigilant examination.
- Prompt diagnosis and intervention by dentists can prevent severe tertiary complications and reduce disease transmission.
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