Luestertiärstadium der Mundhöhle

BACKGROUND: Untreated syphilis or lues is a chronic infectious disease. It is caused by treponema pallidum, which is most commonly transmitted by sexual contact and occasionally by blood transfusion or by intrauterine infection. If the disorder is not treated, its clinical course can be chronic, persisting for decades. During this time, a variety of morphological signs occur depending on the stage of the disease. CASE REPORT: We describe a case of tertiary syphilis in the oropharynx with a defect of the soft palate. In a 37-year-old woman, the first symptom was a dryness of the throat followed by a feeling of foreign body in the palate area. The patient had a history of sexual contact with a man who had had syphilis ten years ago, and our initial suspicion was confirmed by a final diagnosis of tertiary syphilis. Signs of primary or secondary syphilis were not observed. RESULTS: In the course of diagnostic procedures both further manifestatons of syphilis and other infectious or malignant causes were excluded. The serological results showed a typical constellation of Treponema and non-Treponema serum reactions. The histopathological examination of an exploratory excision from the soft palate showed granulomatous changes with peripheral participation of plasma cells. We initiated appropriate antibiotic therapy, using clemizole penicillin G over a period of 21 days, which induced healing of the soft palate. CONCLUSIONS: A defect of the soft palate was diagnosed as a very rare sign of tertiary syphilis.