南予医学雑誌20巻

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－43－南予医誌 Vol.20　No. 1　2020　A 21-year-old man had cold symptoms that did not improve. He developed cervical lymphadenopathy and visited our department for an examination and treatment. Mucosal lesions were seen in the pharynx and tonsils. A bacterial examination of the tonsil mucosa and a tissue needle biopsy of the cervical lymph node were performed, but no signicant results were obtained. A cervical lymph node biopsy was planned to dierentiate between a malignant tumor and autoimmune disease. A preoperative examination before the lymph node biopsy revealed a positive serum syphilis response, and he was diagnosed with secondary syphilis. Treatment was started with 2,000 mg amoxicillin. The pharyngeal mucosal rash disappeared, and swelling of the cervical lymph nodes improved. Syphilis may present as vitiligo in the oral mucosa; a “buttery appearance” in the pharynx is a characteristic of syphilis. Detecting T. pallidum directly from the lesion exudate or tissue is the definitive method for diagnosing early syphilis. It can be diagnosed by taking blood if several weeks have passed since the infection （RPR and TPHA）.However, diagnosis is dicult using either method, unless syphilis is assumed. In this case, the laryngeal mucosal lesion involved cervical lymphadenopathy, and it was necessary to distinguish it from a malignant tumor.Department of Otolaryngology Head and Neck Surgery Uwajima City HospitalGotenmachi,Uwajima,Ehime 798-8510,JapanAbstractYuji Hayashi , Shinji Iwata , Kunihide Aoishi , Tadashi YoshidaA case of pharyngeal syphilis accompanying cervical lymphadenopathyKey words：pharyngeal syphilis, lymphadenopathy, syphilis serum response