Liu Z-Y, Zhang Y, Qiu K-F, Du S-X
Department of Orthopaedics, the First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.
Int J STD AIDS. 2011 Jun;22(6):353-5. doi: 10.1258/ijsa.2011.010387.
Bone infection, particularly of the skull and the long bones of the legs and arms, despite being a common characteristic of tertiary stage syphilis and congenital syphilis in the past, is seldom encountered clinically due to effective antibiotic therapy. We report a case of a 62-year-old man who presented with one-month acute pain in the left leg. Treponema pallidum particle agglutination test was positive, and radiography showed a pathological fracture of the left tibiofibula. Surgical debridement and biopsy of the bone marrow were performed and a pathological diagnosis of syphilis osteomyelitis was entertained. The patient's symptoms resolved completely after a six-week course of penicillin. We identified 17 previously published cases of bone lesions of syphilis, eight of which had syphilitic osteomyelitis, seven were syphilitic osteitis and two had syphilitic periostitis. We suggest that bone lesions such as osteomyelitis caused by syphilis can be the only manifestation of late latent syphilis.
骨感染，尤其是颅骨以及腿部和手臂长骨的感染，尽管在过去是三期梅毒和先天性梅毒的常见特征，但由于有效的抗生素治疗，临床上很少遇到。我们报告一例62岁男性患者，其左腿出现了一个月的急性疼痛。梅毒螺旋体颗粒凝集试验呈阳性，影像学检查显示左胫腓骨病理性骨折。进行了手术清创和骨髓活检，并考虑梅毒骨髓炎的病理诊断。经过六周的青霉素治疗，患者症状完全缓解。我们检索到17例先前发表的梅毒骨病变病例，其中8例为梅毒骨髓炎，7例为梅毒骨炎，2例为梅毒骨膜炎。我们认为，梅毒引起的骨病变如骨髓炎可能是晚期潜伏梅毒的唯一表现。
