口内炎を契機に診断された第二期梅毒の1例

• Published in: 日本口腔外科学会雑誌 Vol. 63; no. 11; pp. 576 - 581
• Main Authors: 濱田, 祐嗣, 唐木田, 一成, 髙橋, 美穂, 坂本, 春生, 鈴木, 大貴, 大野, 啓介
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.11.2017
• Subjects: 口腔粘膜; 性感染症; 梅毒トレポネーマ; 神経梅毒; 第二期梅毒
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.63.576

Syphilis is a sexually transmitted disease caused by a Treponema pallidum infection. We encountered a patient who presented with stomatitis and was given a diagnosis of secondary syphilis. The patient was a 42-year-old woman with chief complaints of difficulty in oral ingestion due to pain in the oral cavity, fever, headache, hair loss, systemic roseola, and keratitis. Serological tests revealed positive results for rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA), forming the basis of our secondary syphilis diagnosis. The bone marrow aspiration test showed positive results for fluorescent treponemal antibody-absorption (FTA-ABS), indicating a neurosyphilis comorbidity. The patient was treated with benzyl penicillin potassium 24 MU/ day for 14 days. Three months after the initiation of treatment, the quantitative value of RPR decreased by 3.7-fold, which indicates cure.　The recent prevalence of same-sex intercourse and oral sex are causing serious problems because sexually transmitted diseases affect not only sexual organs but also the oropharyngeal tract. The departments that treat sexually transmitted diseases are mainly urology, gynecology, and dermatology. However, there is a concern with regard to an increasing number of cases in which sexually transmitted diseases are diagnosed because of oropharyngeal lesions. Therefore, oral surgeons should also become familiar with the diagnosis and treatment of such diseases.