Argemi X, Hansmann Y, Martin M, Lefebvre N, Douiri N, Christmann D, Chanson J-B, Sauer A, De Martino S
Maladies infectieuses et tropicales, nouvel hôpital Civil, 1, quai-Louis-Pasteur, 67000 Strasbourg, France.
Maladies infectieuses et tropicales, nouvel hôpital Civil, 1, quai-Louis-Pasteur, 67000 Strasbourg, France.
J Fr Ophtalmol. 2017 Oct;40(8):654-660. doi: 10.1016/j.jfo.2017.03.007. Epub 2017 Sep 1.
After a decade of constant decline, the number of syphilis cases has been steadily increasing since the 2000s, particularly in HIV infected patients. Neurosyphilis is a rare manifestation of this sexually transmitted disease for which we performed a retrospective study and analyzed clinical manifestations.
We reviewed retrospectively all the neurosyphilis cases admitted to Strasbourg University Hospital between 2004 and 2014. We included and analyzed 13 patients admitted during this period who met the diagnostic criteria for neurosyphilis.
Nine of 13 patients had isolated visual manifestations; three (23.1%) experienced posterior uveitis, two (15.4%), panuveitis, and 4 (30.8%) had papillitis. Out of five patients (38.5%) who were HIV positive, three (60%) had a CD4 cell count above 400/mm at the time of diagnosis of neurosyphilis. All patients received parenteral penicillin G or cephalosporin, and 5/13 (38.5%) received systemic corticotherapy.
Ophthalmologists appear as key players in the identification, management and follow-up of neurosyphilis, since ocular findings are key diagnostic features in these patients.
在经历了十年的持续下降后，梅毒病例数自21世纪以来一直在稳步增加，尤其是在艾滋病毒感染患者中。神经梅毒是这种性传播疾病的一种罕见表现形式，我们对此进行了一项回顾性研究并分析了临床表现。
我们回顾性分析了2004年至2014年期间入住斯特拉斯堡大学医院的所有神经梅毒病例。我们纳入并分析了在此期间收治的13例符合神经梅毒诊断标准的患者。
13例患者中有9例有孤立的视觉表现；3例（23.1%）发生后葡萄膜炎，2例（15.4%）发生全葡萄膜炎，4例（30.8%）发生视乳头炎。在5例（38.5%）艾滋病毒阳性患者中，3例（60%）在诊断神经梅毒时CD4细胞计数高于400/mm³。所有患者均接受了胃肠外青霉素G或头孢菌素治疗，13例中有5例（38.5%）接受了全身皮质类固醇治疗。
眼科医生似乎是神经梅毒识别、管理和随访的关键参与者，因为眼部表现是这些患者的关键诊断特征。
