Janeiro Sérgio, Fernandes Ana Margarida, Lopes Paula, Pedroso Ermelinda
Department of Internal Medicine, Centro Hospitalar de Setúbal, Setúbal, Portugal.
BMJ Case Rep. 2014 Jul 8;2014:bcr2013201473. doi: 10.1136/bcr-2013-201473.
A 59-year-old man with a history of type 2 diabetes and a left nephrectomy following trauma reported of malaise and weakness. He reported a penile ulcer 2 months earlier, but there had been no lymphadenopathy or fever. His speech was slurred, he was breathless on minimal exertion and there was ankle swelling. Twenty-four hours later he developed a generalised maculopapular rash. Laboratory investigation confirmed syphilis and nephrotic syndrome. He was treated with a single injection of benzylpenicillin following which there was a rapid and complete recovery. The temporal association and improvement with treatment suggest that syphilis caused his illness. The incidence of syphilis is increasing and doctors should remain alert to syphilis as a possible cause of the nephrotic syndrome.
一名59岁男性，有2型糖尿病病史，曾因外伤行左肾切除术，自述全身不适、乏力。他称2个月前出现阴茎溃疡，但无淋巴结肿大或发热。他言语含糊不清，轻微活动即感气喘，且有脚踝肿胀。24小时后，他出现了全身性斑丘疹。实验室检查确诊为梅毒和肾病综合征。给予单次注射苄星青霉素治疗后，他迅速完全康复。发病时间与治疗效果之间的时间关联提示梅毒是导致其疾病的原因。梅毒的发病率正在上升，医生应警惕梅毒可能是肾病综合征的病因。
