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梅毒感染的一个特殊病例:“伟大模仿者”正在抬头。

A peculiar case of syphilis infection: The great imitator is on the rise.

作者信息

Eijmael Mjp, Bruin Rg de, Hira V, Koster T

机构信息

Department of Internal Medicine, Groene Hart Ziekenhuis, Gouda, The Netherlands.

Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

IDCases. 2022 May 18;28:e01521. doi: 10.1016/j.idcr.2022.e01521. eCollection 2022.

Abstract

The incidence of syphilis is on the rise worldwide and can pose many diagnostic and therapeutic difficulties for doctors. Given the wide variety of presenting symptoms, syphilis is also known as the great imitator, which in turn frequently leads to a pronounced diagnostic- and therapeutic delay for patients. Here we present a case report of syphilitic uveitis and papillitis accompanied by acute vision loss, a rare presentation of a tertiary syphilis infection that clinically mimicked a giant cell arteritis (GCA) or arteritic anterior ischemic optic neuropathy (AAION). The patient was treated with high-dose intravenous benzyl penicillin after which full vision was restored. By presenting this case, we hope to raise awareness for the increasing incidence of syphilis infections and stress the importance of syphilis testing in patients with otherwise unexplained uveitis.

摘要

梅毒的发病率在全球范围内呈上升趋势,这给医生带来了诸多诊断和治疗上的困难。鉴于梅毒呈现出的症状多种多样,它也被称为“模仿大师”,这反过来又常常导致患者在诊断和治疗上出现明显延误。在此,我们报告一例梅毒相关性葡萄膜炎和视乳头炎病例,该病例伴有急性视力丧失,这是三期梅毒感染的一种罕见表现,临床上酷似巨细胞动脉炎(GCA)或动脉炎性前部缺血性视神经病变(AAION)。该患者接受了大剂量静脉注射苄星青霉素治疗,之后视力完全恢复。通过展示这个病例,我们希望提高对梅毒感染发病率上升的认识,并强调在患有不明原因葡萄膜炎的患者中进行梅毒检测的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5748/9136118/427894fd1ee4/gr1.jpg

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