Syphilisinfektion im HNO-Bereich

Zusammenfassung

Die Anzahl der gemeldeten Syphilis-Fälle steigt seit Jahren an. Die sexuell übertragbare Erkrankung wird durch die Spirochäte Treponema pallidum Subspezies pallidum verursacht und verläuft hierbei in verschiedenen Stadien. In allen Stadien können hierbei Symptome im HNO-Bereich auftreten. Hierdurch ist bei passenden Symptomen eine Syphilis-Infektion als Differenzialdiagnose vom HNO-Arzt stets zu bedenken. So ist bei zunehmendem oralem Geschlechtsverkehr der Primäraffekt/harter Schanker zunehmend häufig im Mundraum zu beobachten. Zudem können Symptome nicht nur im Mundraum, sondern auch im Bereich des Ohrs, der Nase, des Larynx sowie auch zervikal und fazial auftreten. Die Diagnose wird hierbei über den direkten Erregernachweis oder über einen serologischen Nachweis gesichert. Die Spirochäte ist nicht kultivierbar. Der therapeutische Goldstandard ist die Gabe von Benzathin-Penicillin G oder Procain-Penicillin G. Als Alternative stehen Doxycyclin, Makrolide oder Ceftriaxon zur Verfügung. Bei einer Innenohr- oder Hirnnervenbeteiligung ist die zusätzliche Gabe eines Glukokortikoids zu empfehlen. Vor Durchführung der antibiotischen Therapie ist der Patient über die Möglichkeit einer Jarisch-Herxheimer-Reaktion aufzuklären. Bei einer Syphilis-Infektion ist stets eine kollegiale Zusammenarbeit mit den Venerologen zu empfehlen, sodass eine effektive und umfassende Diagnostik und Therapie erfolgen kann.

Abstract

The number of reported cases of syphilis has been increasing for years. The sexually transmitted disease is caused by the spirochete Treponema pallidum subspecies pallidum and progresses in different stages. Symptoms in the ENT area can occur in all stages. This means that a syphilis infection should always be considered by the ENT doctor as a differential diagnosis if the symptoms are suitable. Thus, with increasing oral sexual intercourse, the primary effect/hard chancre is more often observed in the oral cavity. In addition, symptoms can occur not only in the oral cavity, but also in the ear, nose, larynx, cervical and facial regions. The diagnosis is confirmed by direct pathogen detection or by serological detection. The spirochete cannot be cultivated. The therapeutic gold standard is the administration of benzathine penicillin G or procaine penicillin G. Doxycycline, macrolides or ceftriaxone are available as alternatives. In case of inner ear or cranial nerve involvement, the additional administration of a glucocorticoid is recommended. Before antibiotic therapy is administered, the patient must be informed about the possibility of a Jarisch-Herxheimer reaction. In cases of a syphilis infection, a collegial cooperation with the venereologists is always recommended so that an effective and comprehensive diagnosis and therapy can be carried out.

Schlüsselwörter

Syphilis - Lues - sexuell übertragbare Erkrankung - Infektionserkrankung - Treponema pallidum

Keywords

syphilis - lues - STI - STD - sexually transmitted disease - sexually transmitted infection - treponema pallidum

Publication History

Received: 20 May 2021

Accepted after revision: 18 March 2022

Article published online:
08 April 2022

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