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口腔梅毒——善于模仿的大师:六例系列报告。

Oral syphilis - the great imitator: a series of six cases.

机构信息

Division 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.

出版信息

Br Dent J. 2024 Oct;237(7):543-549. doi: 10.1038/s41415-024-7891-9. Epub 2024 Oct 11.

DOI:10.1038/s41415-024-7891-9
PMID:39394298
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11469955/
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.

摘要

梅毒是一种传染病,可表现为多种黏膜皮肤损害。梅毒常被称为“伟大的模仿者”,可表现为非特异性症状,且对多种器官系统具有亲嗜性。口腔已被确定为梅毒感染早期常受累的部位。识别梅毒感染不同阶段的多种表现有助于对该类患者进行早期诊断和治疗。尽管有准确的诊断工具和感染对抗微生物治疗的敏感性,但梅毒感染在全球范围内仍持续上升。我们介绍了六例口腔梅毒患者的临床特征和治疗情况,这些患者均在我院就诊。其中一例于 2008 年就诊,但另外五例分别于 2016 年至 2023 年就诊,反映了梅毒感染的发病率不断上升。五例患者处于感染的二期,而一例患者表现为一期感染,即单个下疳。这些已记录的病例展示了口腔梅毒的非特异性和多变的临床特征,强调了口腔医生对这些表现的认识的重要性。牙医在识别疾病并安排适当的检测以进行早期干预方面发挥着重要作用。这不仅可以降低三级感染的灾难性后果的发生率,还可以减少疾病的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/e56a8bc8ecc2/41415_2024_7891_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/247fca465ac3/41415_2024_7891_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/027f664c331c/41415_2024_7891_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/e29178c635f2/41415_2024_7891_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/d87331b35c70/41415_2024_7891_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/229fd01d6c61/41415_2024_7891_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/e56a8bc8ecc2/41415_2024_7891_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/247fca465ac3/41415_2024_7891_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/027f664c331c/41415_2024_7891_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/e29178c635f2/41415_2024_7891_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/d87331b35c70/41415_2024_7891_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/229fd01d6c61/41415_2024_7891_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11469955/e56a8bc8ecc2/41415_2024_7891_Fig7_HTML.jpg

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本文引用的文献

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The Changing Spectrum of Sexually Transmitted Infections in Europe.欧洲性传播感染的变化趋势
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Oral Syphilis.口腔梅毒
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Syphilis: A great imitator.梅毒:伟大的模仿者。
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Sexually acquired syphilis: Historical aspects, microbiology, epidemiology, and clinical manifestations.性传播梅毒:历史方面、微生物学、流行病学和临床表现。
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Forty cases of acquired oral syphilis and a review of the literature.40 例获得性口腔梅毒病例及文献复习。
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