A disease of great historical significance, though rarely seen today, syphilis is truly protean in its manifestations. T. pallidum demonstrates the ability to invade nearly any tissue or organ system with resulting diverse pathology. It is unusual for an otolaryngologist to make the diagnosis of syphilis, given the initial symptoms of genital lesions and truncal rash. Nonetheless, with the recent trend of increasing incidence and the diffuse head and neck manifestations, it is certainly an entity to keep within the differential diagnosis when evaluating lesions of the head and neck. Otologic symptoms may be of particular interest, as these may sometimes manifest in a patient who is unaware of prior infection and is otherwise in asymptomatic, latent disease.
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