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Abstract：
Syphilis, a disease caused by the bacteria Treponema pallidum, has a multitude of clinical manifestations and is classified into primary syphilis, secondary syphilis and tertiary syphilis, based on clinical presentations and the time elapsed since the primary infection. The secondary stage of the disease can affect multiple organs and systems, and some of these involvements may be general and non-specific, justifying its name as \'the great imitator\'. We present a case of a 30-year-old woman with a history of painful neck lymph nodes with progressive enlargement, persistent headache, weight loss, myalgia and alopecia. During investigations, stomatitis on the dorsal face of the tongue developed. A secondary study showed serum positive for rapid plasma reagin (RPR) and T. pallidum haemagglutination (TPHA), negative RPR in cerebrospinal fluid and normal MRI, thus the diagnosis of secondary syphilis was made. The patient was treated with a single dose of penicillin with complete resolution of symptoms. The case highlights the need for an exhaustive clinical examination, especially in cases presenting with non-specific and general symptoms, and raises awareness for this disease which has increased its prevalence in the last decades.
CONCLUSIONS: Syphilis is a resurgent infection with increasing prevalence, and its manifestations in the secondary stage of the disease are general and non-specific, being able to affect every organ system.The oral mucosa may be involved at any stage of the disease and the tongue, often a neglected organ, can be particularly affected and should be routinely observed.The internist, integrating a cornerstone speciality able to manage and diagnose systemic diseases, must be aware of the individual aspects of the physical examination, notably the appreciation and interpretation of each clue and sign found.
CONCLUSIONS: Syphilis is a resurgent infection with increasing prevalence, and its manifestations in the secondary stage of the disease are general and non-specific, being able to affect every organ system.The oral mucosa may be involved at any stage of the disease and the tongue, often a neglected organ, can be particularly affected and should be routinely observed.The internist, integrating a cornerstone speciality able to manage and diagnose systemic diseases, must be aware of the individual aspects of the physical examination, notably the appreciation and interpretation of each clue and sign found.
摘要：
梅毒,一种由梅毒螺旋体细菌引起的疾病，有多种临床表现，分为原发性梅毒，二期梅毒和三期梅毒，根据临床表现和自原发感染以来经过的时间。疾病的第二阶段可以影响多个器官和系统，其中一些可能是一般性和非特异性的，证明它的名字是“伟大的模仿者”。我们介绍了一例30岁的女性，有颈部淋巴结疼痛的病史，伴有进行性肿大，持续性头痛,减肥,肌痛和脱发。在调查期间,舌头背侧出现口腔炎。一项次要研究显示血清快速血浆反应素（RPR）和梅毒螺旋体血凝（TPHA）呈阳性，脑脊液RPR阴性，MRI正常，因此诊断为二期梅毒。患者接受单剂量青霉素治疗，症状完全缓解。该案例强调了进行详尽的临床检查的必要性，特别是在出现非特异性和一般症状的病例中，并提高了人们对这种疾病的认识，这种疾病在过去的几十年中患病率有所增加。
结论：梅毒是一种随患病率增加而复发的感染，其在疾病的第二阶段的表现是一般的和非特异性的，能够影响每个器官系统。口腔粘膜可能涉及疾病的任何阶段和舌头，通常是一个被忽视的器官，可能会受到特别影响，应该定期观察。内科医生,整合能够管理和诊断系统性疾病的基石专业，必须意识到体检的各个方面，特别是对发现的每个线索和标志的欣赏和解释。
结论：梅毒是一种随患病率增加而复发的感染，其在疾病的第二阶段的表现是一般的和非特异性的，能够影响每个器官系统。口腔粘膜可能涉及疾病的任何阶段和舌头，通常是一个被忽视的器官，可能会受到特别影响，应该定期观察。内科医生,整合能够管理和诊断系统性疾病的基石专业，必须意识到体检的各个方面，特别是对发现的每个线索和标志的欣赏和解释。
