Atypical oropharyngeal presentations of secondary syphilis: two rare case reports
Confederation of European Otorhinolaryngology - Head and Neck Surgery, Gothenburg, Sweden, 25 - 29 April 2026, pp.516-517, (Summary Text)
- Publication Type: Conference Paper / Summary Text
- City: Gothenburg
- Country: Sweden
- Page Numbers: pp.516-517
- Open Archive Collection: AVESIS Open Access Collection
- Uşak University Affiliated: Yes
Abstract
PC030
Background & Aim: Syphilis, caused by Treponema pallidum, has re-emerged globally with diverse clinical manifestations, earning the term “the great imitator.” Oropharyngeal involvement is uncommon and may mimic fungal, bacterial, autoimmune, or neoplastic lesions, posing diagnostic challenges for otorhinolaryngologists. Case Study: We report two cases with atypical oropharyngeal presentations. The first case was a 48- year-old male with a 1.5-month history of sore throat, burning sensation, and occasional hemoptysis. Oropharyngeal examination revealed multiple leukoplakic and pseudomembranous plaques over the tonsils and soft palate, accompanied by epiglottic edema. The second case was a 27-year-old female presenting with a 10-day history of throat discomfort and foreign body sensation. Both patients had no cervical lymphadenopathy or known systemic disease. Initial empirical antimicrobial and antifungal treatments were ineffective. Serologic testing revealed positive VDRL/RPR titers (1:16) in both patients, confirming secondary oropharyngeal syphilis. Each received intramuscular benzathine penicillin G (2.4 million IU weekly for three weeks). Lesions resolved completely within one month in the first case; the second was lost to follow-up after partial improvement. Results: Oropharyngeal syphilis often presents with nonspecific findings. Due to its rarity, other infectious, rheumatologic, or malignant etiologies are typically considered initially. Nonspecific inflammatory lesions of the oropharynx should prompt the inclusion of T. pallidum serology in the diagnostic evaluation, which may prevent unnecessary invasive procedures and facilitate timely treatment. Conclusions: With rising global incidence, syphilis should be considered in the differential diagnosis of atypical, treatment-resistant oropharyngeal lesions. Early recognition and serologic confirmation enable effective therapy and prevent systemic complications.