Frippiat F, Giot J-B, Chandrikakumari K, Léonard P, Meuris C, Moutschen M
Services des maladies infectieuses et d'immunologie, Centre référence sida, Département de médecine interne, CHU Sart Tilman, Liège, Belgique.
Rev Med Suisse. 2008 Aug 27;4(168):1823-7.
Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are divided into early and late stages, including neurosyphilis. The latter can occur during any stage of the disease, leading to the question "when to perform lumbar puncture", particularly in HIV positive patients. Penicillin continues to be the first-line therapy for all stages of syphilis. An alternative treatment should be considered as an exemption, after advice from a specialist. All patients require prolonged clinical and serological follow-up after treatment to rule out relapse or re-infection. The diagnosis of syphilis is an opportunity to search and treat other sexually transmitted diseases in patients and their sexual partner(s).
在经济发达国家，梅毒发病率呈上升趋势，尤其是在男同性恋者和社会经济地位较低的亚人群体中。梅毒的各种临床表现分为早期和晚期，包括神经梅毒。神经梅毒可发生在疾病的任何阶段，这就引出了“何时进行腰椎穿刺”的问题，尤其是在艾滋病毒阳性患者中。青霉素仍然是梅毒各阶段的一线治疗药物。经专家建议后，可将替代治疗作为例外情况考虑。所有患者在治疗后都需要进行长期的临床和血清学随访，以排除复发或再次感染。梅毒诊断为筛查和治疗患者及其性伴侣的其他性传播疾病提供了契机。
