RAPID TEST FOR SYPHILIS: IS IT RELIABLE?

Abstract

Syphilis is a sexually transmitted infection caused by a bacterium (<i>Treponema pallidum</i>) that may present oral manifestations. A 26-year-old male patient presented with a 2-month history of a painful ulcer on the tongue. Medical history revealed low levels of hemoglobin and hematocrit. Intraoral examination showed an ulcer with well-defined borders on the tip of the tongue, measuring 1 cm in diameter. Moreover, erosive lesions with typical characteristics of benign migratory glossitis were seen in the tongue dorsum. The hypotheses for the ulcerated lesion were primary syphilis or ulceration related to anemia. Rapid tests for human immunodeficiency virus and syphilis were negative. A teleconsultation was required, and the oral medicine teleconsultant recommended Venereal Disease Research Laboratory and fluorescent treponemal antibody absorption exams, which confirmed the diagnosis of primary syphilis. The treatment included penicillin G benzathine (2,400,000 UI once a week for 3 weeks). Cases showing features suggesting syphilis require serological tests when rapid tests are negative.