Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Curr Opin Infect Dis. 2020 Feb;33(1):66-72. doi: 10.1097/QCO.0000000000000617.
In the context of a resurgence of syphilis worldwide, it can be anticipated that a rise in cases of ocular, otic, and neurosyphilis will also be seen. This article reviews the current epidemiology, manifestations, and approach to management and treatment.
Although studies continue investigating alternate approaches and new diagnostic tests for ocular and neurosyphilis, few data exist to change current diagnostic algorithms and approaches to diagnosis, management, or follow up.
The diagnosis of neurologic and eye/ear involvement with syphilis may be delayed because of a lack of specificity of findings, low suspicion for syphilis, fluctuation in symptoms, and/or similarities in presentation to other diseases. A high index of suspicion for syphilis and re-education about the protean manifestations of syphilis by all clinicians is required provide timely diagnosis and management of ocular, otic, and neurosyphilis.
随着梅毒在全球范围内的死灰复燃，可以预见眼、耳和神经梅毒的病例也会增加。本文综述了目前的流行病学、表现以及处理和治疗方法。
尽管仍有研究在探讨眼和神经梅毒的替代方法和新的诊断检测，但目前的数据尚不足以改变当前的诊断算法和诊断、处理或随访方法。
由于发现缺乏特异性、对梅毒的怀疑低、症状波动以及与其他疾病表现相似，梅毒引起的神经和眼/耳受累的诊断可能会被延误。所有临床医生都需要对梅毒保持高度怀疑，并接受有关梅毒多形性表现的再教育，以提供及时的诊断和处理眼、耳和神经梅毒。
