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Bandara HMHN, Samaranayake LP. Viral, bacterial, and fungal infections of the oral mucosa: Types, incidence, predisposing factors, diagnostic algorithms, and management. Periodontol 2000 2019; 80:148-176. [PMID: 31090135 DOI: 10.1111/prd.12273] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
For millions of years, microbiota residing within us, including those in the oral cavity, coexisted in a harmonious symbiotic fashion that provided a quintessential foundation for human health. It is now clear that disruption of such a healthy relationship leading to microbial dysbiosis causes a wide array of infections, ranging from localized, mild, superficial infections to deep, disseminated life-threatening diseases. With recent advances in research, diagnostics, and improved surveillance we are witnessing an array of emerging and re-emerging oral infections and orofacial manifestations of systemic infections. Orofacial infections may cause significant discomfort to the patients and unnecessary economic burden. Thus, the early recognition of such infections is paramount for holistic patient management, and oral clinicians have a critical role in recognizing, diagnosing, managing, and preventing either new or old orofacial infections. This paper aims to provide an update on current understanding of well-established and emerging viral, bacterial, and fungal infections manifesting in the human oral cavity.
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Affiliation(s)
| | - Lakshman P Samaranayake
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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2
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Pradhan S, Sirka CS, Panda M, Baisakh M. Lues Maligna in an Immunocompetent Female. Indian Dermatol Online J 2018; 9:344-346. [PMID: 30258808 PMCID: PMC6137667 DOI: 10.4103/idoj.idoj_277_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Swetalina Pradhan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Chandra S Sirka
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Maitreyee Panda
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manas Baisakh
- Department of Pathology, Prolife Diagnostics, Bhubaneswar, Odisha, India
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3
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Huang J, Lin S, Wan B, Zhu Y. A Systematic Literature Review of Syphilitic Hepatitis in Adults. J Clin Transl Hepatol 2018; 6:306-309. [PMID: 30271743 PMCID: PMC6160304 DOI: 10.14218/jcth.2018.00003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 02/12/2018] [Accepted: 03/03/2018] [Indexed: 01/19/2023] Open
Abstract
Syphilitic hepatitis in adults is not frequently found in the population and is easily misdiagnosed. The incidence of viral hepatitis is increasing year by year, concomitantly increasing the importance of obtaining a systematic understanding of the clinical features and treatment strategies for this disease. There is, however, a lack of published definitive data regarding the clinical characteristics, diagnosis and standard treatment options for this disease. Searches were made using the MEDLINE database of PubMed and OVID for syphilitic hepatitis publications from 1951 to 2017 in an attempt to analyze and summarize the clinical characteristics.
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Affiliation(s)
- Jiaofeng Huang
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Su Lin
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Bo Wan
- Institute of Neurology, University College London, London, UK
| | - Yueyong Zhu
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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4
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Cabrera-Fuentes R, Ortiz-Prieto A, Zulueta-Dorado T, Conejo-Mir J. Fever and ulcerative-necrotic lesions in a 38 years old male. Enferm Infecc Microbiol Clin 2017; 36:386-387. [PMID: 28438351 DOI: 10.1016/j.eimc.2017.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Raquel Cabrera-Fuentes
- Servicio de Dermatología y Venereología, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - Alejandro Ortiz-Prieto
- Servicio de Dermatología y Venereología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Teresa Zulueta-Dorado
- Servicio de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Julián Conejo-Mir
- Servicio de Dermatología y Venereología, Hospital Universitario Virgen del Rocío, Sevilla, España
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5
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Rao AG, Swathi T, Hari S, Kolli A, Reddy UD. Malignant Syphilis in an Immunocompetent Adult Male. Indian J Dermatol 2017; 62:318-320. [PMID: 28584378 PMCID: PMC5448270 DOI: 10.4103/ijd.ijd_168_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The occurrence of malignant syphilis in an immunocompetent individual is rare. We present malignant syphilis in a 35-year-old immunocompetent male who presented with a 1-month history of noduloulcerative lesions on the torso. Examination revealed multiple pustules, nodules, and deep-seated ulcers distributed on the trunk, face, and upper and lower limbs. Characteristic morphology of lesions, positive serological tests for syphilis, characteristic histopathology, and resolution of lesions following institution of penicillin therapy confirmed the clinical diagnosis of malignant syphilis.
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Affiliation(s)
| | - T Swathi
- Department of Dermatology, SVS Medical College, Mahbubnagar, Telangana, India
| | - Sharanya Hari
- Department of Dermatology, SVS Medical College, Mahbubnagar, Telangana, India
| | - Amit Kolli
- Department of Dermatology, SVS Medical College, Mahbubnagar, Telangana, India
| | - Uday Deshmukh Reddy
- Department of Dermatology, SVS Medical College, Mahbubnagar, Telangana, India
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6
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Ivars Lleó M, Clavo Escribano P, Menéndez Prieto B. Atypical Cutaneous Manifestations in Syphilis. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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7
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Ivars Lleó M, Clavo Escribano P, Menéndez Prieto B. Atypical Cutaneous Manifestations in Syphilis. ACTAS DERMO-SIFILIOGRAFICAS 2015; 107:275-83. [PMID: 26708562 DOI: 10.1016/j.ad.2015.11.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 10/26/2015] [Accepted: 11/07/2015] [Indexed: 11/16/2022] Open
Abstract
Although the diversity of the clinical manifestations of syphilis is well-known, atypical presentations can also occur. Such atypical presentations are associated with a high risk of transmission as a result of diagnostic confusion and treatment delays owing to the disease's ability to mimic other common skin diseases, deviate from classic clinical presentations, and adopt unique forms. Cases of atypical syphilis have been described most frequently in patients with concomitant human immunodeficiency virus (HIV) infection. Because the incidence of syphilis has been growing over recent years -particularly in patients with HIV co-infection- dermatologists need to be familiar with the less well-known clinical presentations of this venereal disease.
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Affiliation(s)
- M Ivars Lleó
- Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España.
| | - P Clavo Escribano
- Departamento de Dermatología, Centro Sanitario Sandoval, Madrid, España
| | - B Menéndez Prieto
- Departamento de Microbiología, Centro Sanitario Sandoval, Madrid, España
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8
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Requena CB, Orasmo CR, Ocanha JP, Barraviera SRCS, Marques MEA, Marques SA. Malignant syphilis in an immunocompetent female patient. An Bras Dermatol 2015; 89:970-2. [PMID: 25387504 PMCID: PMC4230668 DOI: 10.1590/abd1806-4841.20143155] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 10/16/2013] [Indexed: 12/31/2022] Open
Abstract
Malignant syphilis is an uncommon manifestation of secondary syphilis, in which
necrotic lesions may be associated with systemic signs and symptoms. Generally it
occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on
those who have normal immune response. Since there is an exponential increase in the
number of syphilis cases, more diagnoses of malignant syphilis must be expected. We
report a case in an immunocompetent female patient.
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Affiliation(s)
- Camila Bueno Requena
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Botucatu, SP, Brazil
| | - Cínthia Rosane Orasmo
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Botucatu, SP, Brazil
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9
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Bertrand J, Labrecque LG, Belisle A, Côté B. Lues maligna and Bell’s palsy: report of a case in a immunocompetent host. Int J Dermatol 2012; 51:1363-5. [DOI: 10.1111/j.1365-4632.2011.05169.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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García-Martínez F, Fernández-Redondo V, Sánchez-Aguilar D, Toribio J. Sífilis maligna en un paciente inmunocompetente. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:437-9. [DOI: 10.1016/j.ad.2011.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 05/19/2011] [Accepted: 06/06/2011] [Indexed: 11/25/2022] Open
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11
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García-Martínez F, Fernández-Redondo V, Sánchez-Aguilar D, Toribio J. Malignant Syphilis in an Immunocompetent Patient. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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12
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Rallis E, Paparizos V. Malignant syphilis as the first manifestation of HIV infection. Infect Dis Rep 2012; 4:e15. [PMID: 24470922 PMCID: PMC3892643 DOI: 10.4081/idr.2012.e15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 12/21/2011] [Accepted: 01/02/2012] [Indexed: 11/23/2022] Open
Abstract
Malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by large papular, nodular and ulcerative lesions affecting the trunk and the extremities and covered with thick crust. We present a case of 52-year-old homosexual male who developed malignant syphilis and this was the first clinical manifestation of HIV infection. The patient was treated successfully with intravenous aqueous crystalline penicillin G. Physicians should recognize malignant syphilis and consider it in all HIV-infected individuals with ulceronodular skin lesions.
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Yanagisawa N, Ando M, Imamura A, Akagi K, Horiguchi SI, Suganuma A, Ajisawa A. Pathologically confirmed malignant syphilis in an HIV-infected patient. Intern Med 2011; 50:2423-6. [PMID: 22001480 DOI: 10.2169/internalmedicine.50.5605] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case of pathologically confirmed malignant syphilis in an HIV-infected patient. Physical examinations revealed ulceronecrotic skin lesions. Skin biopsies demonstrated syphilis spirochetes on immunohistochemical stain, and syphilis serological titers were positive. Treatment with intravenous penicillin G was begun, and complete resolution of the skin lesions was observed. A rapid plasma reagin titer test performed 3 months after treatment revealed a 4-fold reduction in the titer, indicating successful treatment.
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Affiliation(s)
- Naoki Yanagisawa
- Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Japan.
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Abstract
BACKGROUND Lues maligna (also known as malignant syphilis or ulceronodular syphilis) is a rare dermatologic manifestation of syphilis more commonly seen in patients with HIV infection. The classic lesion of lues maligna is an oval, papulopustular skin lesion with well demarcated borders sometimes covered with a lamellar crust, but myriad clinical presentations of this disease also exist. GOALS To report a presentation of lues maligna in a patient with probable early HIV infection, emphasizing the diagnostic criteria and clinical manifestations of lues maligna. STUDY DESIGN Case report of lues maligna in a patient with probable early HIV infection. CONCLUSIONS As syphilis becomes more common in many developed regions, it is important to recognize even atypical presentations of this clinical entity, especially among individuals who have unrecognized or early HIV infection.
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15
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Syphilis: the renaissance of an old disease with oral implications. Head Neck Pathol 2009; 3:195-206. [PMID: 20596972 PMCID: PMC2811633 DOI: 10.1007/s12105-009-0127-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 07/02/2009] [Indexed: 10/20/2022]
Abstract
Syphilis is caused by Treponema pallidum an anaerobic filamentous spirochete. In recent years, striking outbreaks have occurred in USA, Canada, Russia, China and some areas of Central and Eastern Europe. Main epidemiology changes reflect sex industry, sexual promiscuity, decreasing use of barrier protection (i.e. condoms) due to false sense of security that nowadays sexually transmitted diseases are curable and lack of pertinent knowledge. Considering that the initial presentation of syphilis may be the oral cavity, it is of great relevance to include this disease in the differential diagnosis of unusual oral ulcerations and white patches. Primary syphilis is a highly infectious disease in which inappropriate treatment may be apparently curative while the patient remains highly infectious. It is then of pivotal importance that clinicians maintain a high clinical index of suspicion. At the present time, clinical-pathologic correlation together with serologic studies remain essential in establishing the diagnosis of syphilis.
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16
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Pérez-Pérez L, Cabanillas M, Ginarte M, Sánchez-Aguilar D, Toribio J. Sífilis maligna en un paciente con infección por el VIH. ACTAS DERMO-SIFILIOGRAFICAS 2007. [DOI: 10.1016/s0001-7310(07)70080-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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17
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Malignant Syphilis in an HIV-Infected Patient. ACTAS DERMO-SIFILIOGRAFICAS 2007. [DOI: 10.1016/s1578-2190(07)70460-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Abstract
Although once on decline in the United States and Europe, the incidence of syphilis has been on the rise since 2000. This increase is noteworthy because there is a high coinfection rate with HIV, especially among men who have sex with men. In light of high coinfection rates, all HIV-infected patients should be tested for syphilis and vice versa. HIV can alter the clinical manifestations of syphilis and, in turn, syphilis has the potential to change the course and transmission of HIV. This article addresses variations in clinical presentation, diagnosis, and management of individuals coinfected with HIV and syphilis.
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Affiliation(s)
- Jill Stevenson
- University of Washington School of Medicine, A-300 Health Sciences Building, Box 356340, Seattle, WA 98195, USA.
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Angus J, Langan SM, Stanway A, Leach IH, Littlewood SM, English JS. The many faces of secondary syphilis: a re-emergence of an old disease. Clin Exp Dermatol 2006; 31:741-5. [PMID: 16901332 DOI: 10.1111/j.1365-2230.2006.02163.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
There has been a recent dramatic re-emergence of syphilis in the UK. This article describes the varied clinical manifestations of secondary syphilis and describes the diagnosis and current guidelines for treatment, especially in association with human immunodeficiency virus infection.
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Affiliation(s)
- J Angus
- Department of Dermatology, Queen's Medical Centre, Nottingham, UK.
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