Syphilitic Chancre of the Tongue  

Oleh:

Staines, Konrad ; Sloan, Philip

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 365 no. 05 (Aug. 2011), page 365:e11.
Topik: Malignancy; Chronic Inflammatory Infiltrate
Fulltext: Syphilitic.pdf (65.13KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

A 41-year-old man presented with a 6-week history of a painful, nonhealing lesion on the dorsum of his tongue. Examination revealed an ulcer with a raised, indurated margin (Panel A). Malignancy and other infections were considered in the differential diagnosis. There was no lymphadenopathy on examination. A chronic inflammatory infiltrate with mature plasma cells and a granulomatous component was evident on incisional biopsy. Immunohistochemical staining for Treponema pallidum identified spirochetes in the granulation tissue overlying the ulcer, as well as in the walls and lumen of the capillaries at its margin (Panel B, arrows). A strongly positive treponemal antibody absorption test and particle agglutination assay (titer =1:1280) and a second-line enzyme immunoassay confirmed these findings. The tongue ulcer was diagnosed as a primary syphilitic chancre. The results of screening tests for the human immunodeficiency virus, chlamydia, and Neisseria gonorrhoeae were negative, and the patient was referred to public health officials for sexual-contact tracing. Standard treatment with a single intramuscular injection of benzathine penicillin G resulted in rapid pain relief and complete resolution of the chancre over a 3-week period.

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