- 期刊
梅毒及其口內潰瘍病灶表徵－病例報告
Syphilis and Oral Manifestations-A Case Report
摘要
很多系統性疾病發生感染後，容易使口腔組織崩解而造成黏膜潰瘍或糜爛，因此出現口腔病灶。梅毒在已發展國家中雖不普遍，但有逐漸增加的趨勢。本報告病例爲一31歲男性，與高血壓糖尿病病史，主訴爲下唇內面黏膜處有二十多天未癒合且疼痛的潰瘍，因此至本院求診。口內檢查發現從下唇至右後方的臼齒後三角區有數個潰瘍，頸部林巴結沒有明顯的腫大。患者自述在4個多月前，在其外生殖器上也出現類似的白色斑塊。因此，臨床上懷疑口腔的病灶爲梅毒造成之黏膜斑。患者於當天接受切片檢查及血清試驗。病理組織檢查只有非特異性的發炎反應與潰瘍，特殊染色下也沒有觀察到致病的螺旋體，但是血清檢查呈現陽性反應，間接證實口腔的病灶爲梅毒引起之黏膜斑。於是在告知患者結果後將他轉診到感染科接受治療。疼痛性的口內潰瘍可能造成的原因很多，除了一般的口內檢查之外，問診及身體理學檢查更顯重要。尤以第二期梅毒具高度感染性，進行醫療行爲時須謹慎。
並列摘要
Many systemic diseases demonstrate oral ulcers or erosions due to tissue break down after the infection. Here we reported a case that was a 31-year-old man and was otherwise healthy. He complained oral ulcerations over lower labial area that was painful and not healed for more than 20 days. In oral examination, several ulcers over lower lip, right retromolar trigone were noted. After taking his history, he admitted that there was a whitish patch at his genital sites 4 months ago mimicking the oral lesions. The genital lesion disappeared after application of topical medication by himself. Accordingly, mucous patch of syphilis was suspected clinically. An incisional biopsy was performed on that day and serologic tests were studied. Histopathological evaluation did not show specific findings nor detection of spiral bacterium. However, VDRL showed 64X, TPHA showed 5120 X which supported the diagnosis of syphilis. Patient was referred to the Infection Clinic for further treatment.