If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Corresponding author at: Department of HIV Clinic, Nagoya Medical Center, National Hospital Organization, 4-1-1 Sannomaru Naka-ku, Nagoya, Aichi 460-0001, Japan.
A 51-year-old man infected with HIV for more than 10 years visited our HIV clinic due to lesions in his throat. He had a CD4 T-cell count of >500 cells per μl and a HIV-RNA viral load of <20 copies per mm3. Nearly 3 months before this presentation, the patient participated in oral sex. At the clinic, he presented with a milky and (Fig. 1A ). He did not have any other symptoms on his skin.
Fig. 1A milky and symmetrical mucosal erosion in the patient's soft palate (panel A).
The patient had a history of syphilis 4 years prior to this visit. Although he was treated with amoxicillin 4 years prior, his serological tests for syphilis (STS) titer had remained positive at a low level. Laboratory testing revealed that his rapid plasma reagin (RPR) test result increased from 1:4 to 1:512 (normal value, <1), and his Treponema pallidum hemagglutination (TPHA) level had increased from 1280 to >40,960 (normal value, <1).
]. Notably, HIV patients often demonstrate prolonged STS positivity even after appropriate treatment. Thus, it is hazardous to diagnose syphilis solely based on a serological test. Pharyngeal syphilis accounts for 7% of syphilis cases [
]. The patient was treated with amoxicillin for a month, and the symptoms of pharyngeal lesions resolved rapidly. The picture shows the patient's soft palate after 2 months of follow-up (Fig. 1B).
Conflicts of interest
The authors disclose no financial or proprietary conflicts of interest with this publication.
Consent
Consent was obtained and no patient identifiers are evident on the clinical image.
References
Imahashi M.
Izumi T.
Watanabe D.
Imamura J.
Matsuoka K.
Ode H.
et al.
Lack of association between intact/deletion polymorphisms of the APOBEC3B gene and HIV-1 risk.
30089-X&id=gr1.jpg){kind=link}