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Full text of "Diseases Of The Nose Throat And Ear"

CHAPTER 8
SPECIFIC NASAL INFECTIONS

SYPHILIS

Inherited Syphilis. This may appear in the form of coryza (snuffles) beginning
in the first 3 months of life. It is characterized by an obstinate nasal discharge
which tends to dry up and form crusts, while the irritation of the secretion
causes fissures to appear at the anterior nares. At a later stage, usually at
puberty but sometimes not until adult life, gummatous ulceration may
destroy the tissues and lead to atrophy and scarring, so that the bridge of the
nose is depressed and foetid crusts form within the nasal cavity. The permanent
teeth and the cornea show the well-known defects (Fig. 22). In infants so

Fig. 22. Stigmata of congenital syphilis. Hutchinson's teeth. Sunken bridge. Coraeal opacities.

affected other evidence of the disease should be looked for and the family
history must also be investigated.

Acquired Syphilis. Primary infections of the nose are very rare. Secondary
lesions in the form of mucous patches are met with less commonly than in the
pharynx, and only slight symptoms are produced. In its tertiary form syphilis
may occur in the nasal cavities. The septum is most commonly involved, but
the lateral wall of the nose may also be affected. The stage of gummatous
infiltration is rarely seen because, as a rule, ulceration and destruction of tissue
have taken place before the patient is examined. The gumma takes the form of

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