Clinical Spectrum of Oral Secondary Syphilis in HIV-Infected Patients.

Journal of sexually transmitted diseases Pub Date : 2013-01-01 Epub Date: 2012-12-17 DOI:10.1155/2013/892427
Velia Ramírez-Amador, Gabriela Anaya-Saavedra, Brenda Crabtree-Ramírez, Lilly Esquivel-Pedraza, Marcela Saeb-Lima, Juan Sierra-Madero
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引用次数: 21

Abstract

Background. Oral lesions may constitute the first clinical manifestation in secondary syphilis, but detailed descriptions in HIV-infected individuals are scarce. Objective. To describe the clinical characteristics of oral secondary syphilis in HIV-infected patients and its relevance in the early diagnosis of syphilis. Methods. Twenty HIV/AIDS adult subjects with oral secondary syphilis lesions presenting at two HIV/AIDS referral centers in Mexico City (2003-2011) are described. An oral examination was performed by specialists in oral pathology and medicine; when possible, a punch biopsy was done, and Warthin-Starry stain and immunohistochemistry were completed. Intraoral herpes virus infection and erythematous candidosis were ruled out by cytological analysis. Diagnosis of oral syphilis was confirmed with positive nontreponemal test (VDRL), and, if possible, fluorescent treponemal antibody test. Results. Twenty male patients (median age 31.5, 21-59 years) with oral secondary syphilis lesions were included. Oral lesions were the first clinical sign of syphilis in 16 (80%) cases. Mucous patch was the most common oral manifestation (17, 85.5%), followed by shallow ulcers (2, 10%) and macular lesions (1, 5%). Conclusions. Due to the recent rise in HIV-syphilis coinfection, dental and medical practitioners should consider secondary syphilis in the differential diagnosis of oral lesions, particularly in HIV-infected patients.

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hiv感染者口腔二期梅毒的临床特征。
背景。口腔病变可能是继发性梅毒的首要临床表现,但对hiv感染者的详细描述很少。目标。探讨hiv感染者口腔二期梅毒的临床特点及其与梅毒早期诊断的相关性。方法。本文描述了2003-2011年在墨西哥城两家HIV/AIDS转诊中心就诊的20名患有口腔继发性梅毒的HIV/AIDS成人受试者。由口腔病理学和医学专家进行口腔检查;如有可能,行穿刺活检,完成Warthin-Starry染色和免疫组化。细胞学分析排除口腔内疱疹病毒感染和红斑念珠菌病。非梅毒螺旋体试验(VDRL)阳性,如果可能,荧光梅毒螺旋体抗体试验证实口腔梅毒的诊断。结果。纳入20例男性口腔继发性梅毒患者(中位年龄31.5岁,21-59岁)。口腔病变是16例(80%)梅毒的第一个临床症状。口腔粘膜斑块是最常见的口腔表现(17.85.5%),其次是浅溃疡(21.10%)和黄斑病变(1.5%)。结论。由于最近艾滋病毒-梅毒合并感染的增加,牙科和医疗从业人员在口腔病变的鉴别诊断中应考虑继发性梅毒,特别是在艾滋病毒感染患者中。
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