Up Above
Immune System
Step 1: View Clinicals
A 32 year old man presents with a painless oral ulcer for one week.
Further questioning reveals that he had unprotected orogenital sex with two separate partners during the preceding month.
He is otherwise well, with an unremarkable medical history.
A 32 year old man presents with a painless oral ulcer for one week.
Further questioning reveals that he had unprotected orogenital sex with two separate partners during the preceding month.
He is otherwise well, with an unremarkable medical history.
Step 2: Order Relevant Investigations
1. Dark field microscopy
You remember that dark field microscopy of oral lesions is not recommended.
2. Rapid Plasma Reagin
The Rapid Plasma Reagin test is strongly reactive.
3. TPPA
The Treponema pallidum Particle Agglutination assay is reactive.
4. Biopsy of ulcer
A biopsy will be arranged next week.
1. Dark field microscopy
You remember that dark field microscopy of oral lesions is not recommended.
2. Rapid Plasma Reagin
The Rapid Plasma Reagin test is strongly reactive.
3. TPPA
The Treponema pallidum Particle Agglutination assay is reactive.
4. Biopsy of ulcer
A biopsy will be arranged next week.
Step 3: Select Appropriate Management
1. Metronidazole
2. Penicillin
3. Acyclovir
4. Topical Corticosteroids
1. Metronidazole
2. Penicillin
3. Acyclovir
4. Topical Corticosteroids