Description of clinical cases and available diagnostic tools of oropharyngeal syphilis: a systematic review of the literature.

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES BMC Infectious Diseases Pub Date : 2024-11-06 DOI:10.1186/s12879-024-10129-1
Pierre Guarino, Francesco Chiari, Carlo Carosi, Giustino Parruti, Claudio Donadio Caporale, Livio Presutti, Gabriele Molteni
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Abstract

Introduction: Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Head and neck mucosal manifestations of syphilis can be observed in each and all of primary, secondary and tertiary syphilis, especially in the secondary one. Therefore, oropharynx is an unusual localization of syphilitic lesions, mainly represented by ulcerous lesions, tissue hypertrophy, mucosal patches and cancer-like lesions. Serology is routinely considered the gold standard for the screening and diagnosis of syphilis. However, direct detection is routinely used during polymerase chain reaction (PCR) of oropharyngeal tissue and suspicious cervical lymphadenopathies.

Methods: PRISMA 2020 guidelines were applied to make a systematic literature review with the aim to make an overview of clinical manifestations and diagnostic tools of oropharyngeal syphilitic infection. A computerized MEDLINE search was performed using the PubMed, Web of Science and Cochrane databases.

Results: The intended analysis was based on 38 papers, including a total of 55 cases. The main localization of oropharyngeal infection was the tonsil (71%), followed by lateral and posterior wall of oropharynx (16%). Ulcerous lesions were the most frequently encountered lesions in the primary syphilis (56%) and secondary syphilis (36%), whereas gumma's lesions were encountered in the tertiary syphilis (57%). Diagnosis based on serological assays was used in combination with non-treponemal methods to determine disease activity (80% cases).

Conclusions: Oropharyngeal syphilis has historically been referred to as the "great imitator" due to its highly variable manifestations, which can resemble malignancies. Physicians have to recognize oropharyngeal luetic features early, in order to set up an effective diagnostic and therapeutic work-up.

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口咽梅毒临床病例和可用诊断工具的描述:文献系统回顾。
导言:梅毒是由苍白螺旋体引起的全身性细菌感染。梅毒的头颈部黏膜表现在原发性、二期和三期梅毒中均可见到,尤其是二期梅毒。因此,口咽部是梅毒病变的不常见部位,主要表现为溃疡性病变、组织肥大、粘膜斑块和癌样病变。血清学通常被认为是筛查和诊断梅毒的金标准。然而,在对口咽组织和可疑宫颈淋巴结病进行聚合酶链反应(PCR)时,通常会使用直接检测法:方法:采用 PRISMA 2020 指南进行系统性文献综述,旨在概述口咽部梅毒感染的临床表现和诊断工具。利用PubMed、Web of Science和Cochrane数据库对MEDLINE进行了计算机检索:预期分析基于 38 篇论文,共包括 55 个病例。口咽感染的主要部位是扁桃体(71%),其次是口咽侧壁和后壁(16%)。溃疡是一期梅毒(56%)和二期梅毒(36%)中最常见的病变,而在三期梅毒(57%)中则会出现古马病变。根据血清学检测进行诊断,并结合非抗梅毒法确定疾病的活动性(80%的病例):口咽梅毒的表现千变万化,可能与恶性肿瘤相似,因此历来被称为 "伟大的模仿者"。医生必须及早识别口咽梅毒的特征,以便制定有效的诊断和治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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