Sífilis secundaria en un paciente VIH positivo
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López Ortega, Karem; Rezende, Nathalie Pepe Madeiros; Watanuki, Fernando; Araujo, Ney; Magalhaes, Marina H.C.G.
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Aquest document és un/a article, creat/da en: 2004
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La incidencia de afecciones orales, antes infrecuentes en pacientes
infectados por VIH, se está incrementando y es posible
que se subestime.
Las lesiones orales resultantes de la sífilis secundaria son raras;
sin embargo, ocurren, y el odontólogo debería ser capaz de
realizar un correcto diagnóstico. En algunos casos la anámnesis
y los signos clínicos de las lesiones son insuficientes para permitir
el diagnóstico de la enfermedad. El conocimiento de sus
características histológicas y las pruebas de laboratorio relevantes,
así como su aplicabilidad y limitaciones son necesarios
para el correcto diagnóstico de la sífilis secundaria.The incidence of oral manifestations of HIV infection is changing
markedly. Oral afflictions previously uncommon in HIV condition
are now emerging in this scenario and may be underestimated. Clinical characteristics of some oral diseases could change in
the presence of HIV/AIDS infection and health care
professionals must be made aware of such changes.
Oral lesions of secondary syphilis are rare, however they can
occur and the dentist should be able to diagnose them. In some
cases the anamnesis and the clinical features of the lesions are
not enough to diagnose this disease. Histological features and
an acute knowledge on laboratory exams, as well as its
applicability and limitations are necessary to diagnose it.
The present report describes a case of secondary syphilis in an
HIV positive patient. The patient showed red spots in the torso's
skin and abdomen. The spots were also present on the hands
but the color was darker. The oral mucosa had several ulcers,
with variable shapes, sometimes recovered by a white and
resistant membrane. They were present in the buccal mucosa,
palate, gingiva, tongue and labial mucosa. Those clinical
manifestations appeared 6 months earlier. Exams were
performed (VDRL, FTA-abs, direct fungal exams in the skin
and oral mucosa and a biopsy in the oral mucosa) but the
diagnose remained unclear.
Clinical and laboratory features disagreed and postponed the
final diagnosis and the treatment for more than 6 months. |
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