Not your usual tonsillitis: a lesson for recognizing primary tonsillar syphilis

Wu, Ruo-bin; Babik, Jennifer M.; Russell, Matthew B.; Zante, Annemieke van; Chan, Emily

doi:10.1111/his.14712

Cited by 1 publication

(2 citation statements)

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“…Previous case reports of syphilitic tonsillitis published in English are summarised in table 1 4–10 15–22. Laterality of tonsil and cervical lymphadenopathy are not useful in distinguishing between primary and secondary syphilis (online supplemental table 1).…”

Section: Discussionmentioning

confidence: 99%

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Unilateral tonsillitis due to primary syphilis with gram-negative corkscrew-like spirochaetes confirmed by Gram stain of pus

Taniguchi,

Yamamoto,

Miyoshi

et al. 2024

BMJ Case Rep

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A man in his 40s presented with pharyngeal pain and right cervical lymphadenopathy that persisted for 1 month. His right tonsil was swollen and covered with exudate; however, a rapid streptococcal antigen test was negative. Rapid plasma reagin andTreponema pallidumantibody were positive. Gram staining of the pus confirmed the presence of gram-negative corkscrew-like spirochaetes. The patient had unprotected oral intercourse. He did not have any skin lesions. He was diagnosed with primary syphilis and treated with benzathine penicillin G. In adults, the differential diagnosis of tonsillitis should include sexually transmitted diseases. A rapid streptococcal antigen test is not sufficient for such a case; a syphilis test is necessary, and Gram staining, which is rapid and does not need any special equipment, can support the diagnosis.

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Section: Discussionmentioning

confidence: 99%

“…Unless serological tests for syphilis are measured, diagnosis of syphilitic tonsillitis tends to be delayed 7. Some tonsillitis of primary syphilis could develop into secondary syphilis,5 8 or invasive procedures such as biopsies8 9 to investigate malignancy or even tonsillectomy5 10 might be performed.…”

Section: Introductionmentioning

confidence: 99%