Pföhler Claudia, Koerner Rebecca, von Müller Lutz, Vogt Thomas, Müller Cornelia S L
Department of Dermatology, Saarland University Hospital, Homburg/Saar, Germany.
BMJ Case Rep. 2011 Jul 27;2011:bcr0520114221. doi: 10.1136/bcr.05.2011.4221.
Lues maligna represents a rare form secondary syphilis and is also known as 'malignant syphilis' or 'ulceronodular syphilis'. This clinical entity is predominantly found in immunodeficient patients such as patients with HIV or AIDS. The patient presented here suffered from unspecific symptoms such as painful joints, headache, flu-like symptoms and a disseminated exanthema presenting with ulcerating nodules for 1 week. He further reported a 7 weeks history of painless ulcer, involving his external genitals and anus. Unsafe sexual contacts were strictly denied first, but as serological investigation could prove active syphilis and HIV infection, the patient finally stated promiscuous unprotected homosexual contacts in the past. He was treated with penicillin G intravenously three times daily. The unspecific flu-like symptoms disappeared quickly within several days, all skin lesions healed, partly with scars after 2 weeks.
恶性梅毒是二期梅毒的一种罕见形式，也被称为“恶性梅毒”或“溃疡结节性梅毒”。这种临床病症主要见于免疫缺陷患者，如艾滋病毒感染者或艾滋病患者。此处所报告的患者出现了一些非特异性症状，如关节疼痛、头痛、流感样症状以及伴有溃疡性结节的播散性皮疹，持续了1周。他还报告有7周无痛性溃疡病史，累及外生殖器和肛门。患者最初坚决否认有不安全的性接触，但由于血清学检查证实存在活动性梅毒和艾滋病毒感染，患者最终承认过去有过杂乱无保护的同性恋接触。患者接受了每日3次静脉注射青霉素G的治疗。数天内，非特异性的流感样症状迅速消失，所有皮肤损害均愈合，2周后部分留有瘢痕。
