Bipin Kishore Prasad1* and Suresh Mokamati2
1Military Hospital, Kirkee, Range Hills, Pune – 411020, Maharashtra, India
2Armed Forces Medical College, Pune, India
Received: 02 March, 2016; Accepted: 23 March, 2016; Published: 25 March, 2016
BK. Prasad, Professor of ENT, Military Hospital, Kirkee, Range Hills, Pune – 411020, Maharashtra, India, Tel: +91 8698075965; E-mail:
Prasad BK, Mokamati S (2016) Tertiary Nasal Syphilis: Rare But Still a Reality. Arch Otolaryngol Rhinol 2(1): 013-015. DOI: 10.17352/2455-1759.000014
© 2015 Prasad BK, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Tertiary syphilis shows most marked manifestations in the nose causing superficial and deep ulcerations and gumma. Gummatous deposit may occur in any portion of the nose. The deformity resulting from the destruction of the bony frame work of the nose and the shrinking of fibroid tissue produces typical saddle nose which is characteristic of syphilis. It is important to establish the diagnosis after carefully ruling out other clinical possibilities and confirming Treponemal infection by laboratory evaluation. The respiratory tract, next to skin, furnishes the most frequent manifestations of syphilis. Syphilis of the nose is acknowledged by all authorities to be very rare. One such case is reported for its rarity.
An 81 years old male presented with complaints of nasal discharge and crusting for 3 years, anosmia for 1 year and nasal deformity since 6 months. Nasal discharge was mucoid but viscid, associated with crusting, nasal obstruction and occasional epistaxis. Nasal deformity, in the form of depression of nose, gradually worsened and developed into a saddle, associated with redness over nose and surrounding area. He also recounted 4 episodes of shedding of fleshy bits from nose in last 6 months. The patient, however, denied any complaint of trauma to nose, cough, chest pain, dyspnoea, hematuria, sexual promiscuity (last sexual contact with wife 15-20 years back), anaesthetic skin patches, raised lesions on skin, joint pains, redness or swelling of pinna, mouth or genital ulcers, redness of eyes, diabetes, hypertension or weight loss.
His vital signs were found to be normal. External nasal framework showed saddle nose involving bony as well as cartilaginous portion (Figure 1), swelling at right side of nose, ulceration at philtrum, vestibule and nasal tip and destruction of the nasal septum (Figure 2).