매독성 인후염, Syphilitic Pharyngitis

Syphilitic Pharyngitis (google image search)

1. Syphilitic Pharyngitis는 acute pharyngitis 원인 중의 하나이다.

 

2. Syphilitic Pharyngitis는 secondary syphilis에 해당한다.

Approximately 25 percent of individuals with untreated primary infection will develop a systemic illness that represents secondary syphilis. Clinical manifestations are protean, but often include a disseminated rash, condylomata lata, lymphadenopathy, alopecia, and/or hepatitis.

3. Early syphilis에 해당하는 primary, secondary, early latent syphilis의 표준 치료제는 penicillin G benzathine (2.4 million units intramuscularly [IM])이지만, 페니실린 알레르기 또는 penicillin G benzathine이 없는 경우 대안적 치료제로서 독시사이클린, 세프트리악손, 아목시실린 plus probenecid가 있다. 대안 치료제는 신경학적, 눈, 귀 증상, 임신 환자에서는 피한다.

N Engl J Med 2024; 390:934

	Clinical manifestations*	Treatment¶	Monitoring after treatmentΔ
Early syphilis	Primary syphilis: Typically consists of a single painless chancre at the site of inoculation, accompanied by regional adenopathy. ​ Secondary syphilis: A systemic illness that often includes a rash (disseminated and/or involving the palms and soles), fever, malaise, and other symptoms such as pharyngitis, hepatitis, mucous patches, condyloma lata, alopecia. ​ Early latent: Refers to the period when a patient is infected with Treponema pallidum as demonstrated by serologic testing but has no symptoms. Early latent syphilis occurs within the first year of initial infection.	Preferred: Penicillin G benzathine 2.4 million units IM once Alternatives (choose one):◊ Doxycycline 100 mg orally twice daily for 14 days§ Ceftriaxone 1 g daily IM or IV for 10 to 14 days	Clinical exam and serologic testing with a nontreponemal test (eg, RPR) at 6 and 12 months. Titers should be checked more frequently if the patient is HIV infected, follow-up is uncertain, or reinfection is a concern.

Ref. UpToDate 2024.03.10

N Engl J Med 2024; 390:934