Johns Hopkins University School of Medicine, Baltimore, MD.
Sex Transm Dis. 2018 Sep;45(9S Suppl 1):S10-S12. doi: 10.1097/OLQ.0000000000000851.
Despite over a century of clinical experience in diagnosing and managing patients with syphilis, many thorny clinical questions remain unanswered. We focus on several areas of uncertainty for the clinician: the role of serologic tests in diagnosing syphilis and assessing syphilis treatment responses, and the risk of neurosyphilis and ocular syphilis in patients with syphilis. We also address whether clinical approaches should differ in patients who are, and are not, infected with HIV. The current increases in syphilis rates in the United States and elsewhere underscore our urgent need to definitively address these issues.
尽管在诊断和治疗梅毒患者方面已有一个多世纪的临床经验,但仍有许多棘手的临床问题尚未得到解答。我们重点关注临床医生面临的几个不确定领域:血清学检测在诊断梅毒和评估梅毒治疗反应中的作用,以及梅毒患者发生神经梅毒和眼梅毒的风险。我们还探讨了在感染 HIV 的患者和未感染 HIV 的患者中,临床处理方法是否应该有所不同。目前美国和其他地方梅毒发病率的上升突出表明,我们迫切需要明确解决这些问题。