Moderate inhalation injury refers to injury above the tracheal ramus, including the pharynx and trachea. Causes Syphilis is a chronic infectious disease caused by the syphilis spirochete, which is a type of venereal disease. The initial infection is systemic and can involve any organ or tissue as it progresses. Esophageal syphilis is extremely rare and is mainly a stage III syphilis. The pathogenesis of esophageal syphilis does not differ from syphilis lesions in other parts of the body, except for the dendritic swelling, which is primarily a vascular lesion from the beginning to the end. Late syphilis is caused by inflammatory changes and necrosis due to occlusive endarteritis of the small terminal arteries and arterioles. In general, the lesions of stage III syphilis present as submucosal dendrites or diffuse inflammation with tissue destruction, both of which can lead to scarring strictures by erosions and ulcers. Examination Difficulty in swallowing is the most common symptom of esophageal syphilis, which is mostly painless and characterized by a long and slow progression of the disease, unlike esophageal cancer. When the lesion progresses, dysphagia and retrosternal pressure can occur even when eating liquids, which can lead to weight loss, dehydration, anemia and even cachexia due to insufficient intake. Once the dendritic swelling leads to a tracheoesophageal (broncho-esophageal) fistula, choking and coughing may occur during feeding. In addition, other symptoms of esophagitis and obstruction may also occur.