Tertiary Treponematosis of the Nasal Cavity – Oral Medicine Case Book

Both genital and non-genital treponematoses are overtly similar in pathogenesis, natural history and histologic features. In the head and neck, a relatively small percentage of untreated, infected patients may progress from latency to tertiary disease, with perforation or collapse of the palate and nasal septum. Due to the rarity of tertiary disease and the non-specific histomorphologic features, the disease may go undiagnosed, often with dire consequences. Clinicopathological correlation, a high index of suspicion and a judicious mix of histological and immunohistochemical stains may help the pathologist in arriving at the correct diagnosis. In this article, we report a unique case of nasal treponematosis in a young South African male, discussing the clinical findings, histological features and diagnostic methods of detection.