Syphilitic Tonsillitis as Differential Diagnosis of Angina

Introduction: Syphilis is an infectious disease with predilection to the genital system; however, some cases may present extragenital manifestations as syphilitics tonsillitis. The oral manifestations of syphilis may occur in any one of the three stages of the disease. In the primary stage, tonsils are congest, edematous, and hardened. In the secondary stage, the oroscopy presents circular elevated enanthematous, opaline plaques in the mucosa, recovered with white-gray membrane, rounded with redness halo in the tonsils, buccal mucosa, and palate. The tertiary stage presents chronic and deep ulcerations reaching muscle layer of the oropharynx, but painless.

Objectives: The aim of this study is to present a case of syphilitic tonsillitis that occurred in a private hospital, exposing the relevant aspects for the differential diagnosis of anginas.

Resumed Report: ACA, 29-year-old male patient (A.C.A.) suffering from sore throat in the past 3 months, was feverless, and the symptoms worsened in the past 10 days. Physical examination revealed the following: lymph nodes enlarged in all of the cervical chains, oroscopy presented ulcerations in tonsils and soft palate, and buccal mucosa recovered with white-gray membrane. Painkillers were prescribed and serological tests were administered as an oropharynx swab. On the return, tests were positive for syphilis and the treatment with penicillin benzathine penicillin, 2,400,000 units split in two doses, began. After 15 days, he presented remission of all the symptoms.

Conclusions: Although rare in private hospitals, the ENT doctor might always consider the syphilitic tonsillitis as a differential diagnosis and be able to provide the appropriate treatment.

Keywords: syphilis, tonsillitis, infectious diseases.