SECONDARY SYPHILIS MANIFESTING AS MULTIFOCAL ORAL ULCERATIONS, DYSPHONIA, AND CERVICAL LYMPHADENOPATHY: A CASE REPORT
Keywords:
Syphilis, Secondary syphilis, Oral ulcerations, Cervical lymphadenopathy, TPHAAbstract
This case exemplifies a diagnostically intricate scenario of secondary syphilis, marked by painful multifocal oral lesions, dysphonia, and cervical lymphadenopathy, which initially mimic inflammatory or malignant disorders. Secondary syphilis has experienced a worldwide resurgence and can manifest with diverse mucocutaneous symptoms. Oral lesions may serve as the sole initial clinical sign, resulting in misdiagnosis and postponed treatment. A 50-year-old female patient presented with painful multifocal oral ulcerations persisting for four months, along with dysphagia, hoarseness, and bilateral cervical lymphadenopathy. Written informed consent was obtained. A thorough clinical evaluation, serological analysis, cervical lymph node cytology, ENT examination, and imaging studies were conducted. Fiberoptic laryngoscopy revealed epipharyngeal swellings and edema of the vocal folds. Serological tests were indicative of secondary syphilis. Despite receiving counseling, the patient declined biopsy and treatment. The diagnosis was confirmed through clinical correlation and serological evidence. This case highlights the necessity for enhanced clinical awareness of syphilis in patients who present with persistent oral ulcers and systemic symptoms. Early identification is crucial to avert complications; however, the patient's refusal of care poses a significant obstacle to effective management.
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Copyright (c) 2026 Bojan Poposki, Vera Radojkova-Nikolovska, Kristina Mitikj, Nada Risteska, Sanela Idoska, Martina Anastasovska, Stjepanka Lešić, Vlatko Kokolanski
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