MMWR Morb Mortal Wkly Rep. 2023 Nov 24;72(47):1281-1287. doi: 10.15585/mmwr.mm7247a1.
Untreated syphilis can lead to ocular syphilis, otosyphilis, and neurosyphilis, conditions resulting from Treponema pallidum infection of the eye, inner ear, or central nervous system. During March-July 2022, Michigan public health officials identified a cluster of ocular syphilis cases. The public health response included case investigation, partner notification, dissemination of health alerts, patient referral to a public health clinic for diagnosis and treatment, hospital care coordination, and specimen collection for T. pallidum molecular typing. Five cases occurred among southwest Michigan women, all of whom had the same male sex partner. The women were aged 40-60 years, HIV-negative, and identified as non-Hispanic White race; the disease was staged as early syphilis, and all patients were hospitalized and treated with intravenous penicillin. The common male sex partner was determined to have early latent syphilis and never developed ocular syphilis. No additional transmission was identified after the common male partner's treatment. Due to lack of genetic material in limited specimens, syphilis molecular typing was not possible. A common heterosexual partner in an ocular syphilis cluster has not been previously documented and suggests that an unidentified strain of T. pallidum might have been associated with increased risk for systemic manifestations of syphilis. A high index of clinical suspicion and thorough sexual history are critical to diagnosing ocular syphilis, otosyphilis, and neurosyphilis. Coordination of disease surveillance with disease intervention specialist investigation and treatment referral can interrupt syphilis transmission.
未经治疗的梅毒可导致眼部梅毒、耳部梅毒和神经梅毒，这些疾病是由梅毒螺旋体感染眼睛、内耳或中枢神经系统引起的。在 2022 年 3 月至 7 月期间，密歇根州公共卫生官员发现了一组眼部梅毒病例。公共卫生应对措施包括病例调查、性伴侣通知、发布健康警报、将患者转介到公共卫生诊所进行诊断和治疗、医院协调护理以及采集梅毒螺旋体分子分型标本。这 5 例发生在密歇根州西南部的女性中，所有患者都有相同的男性性伴侣。这些女性年龄在 40 至 60 岁之间，HIV 检测呈阴性，被认定为非西班牙裔白人；疾病处于早期梅毒阶段，所有患者都住院并接受了静脉注射青霉素治疗。共同的男性性伴侣被确定患有早期潜伏梅毒，从未出现眼部梅毒。在共同男性伴侣接受治疗后，没有发现其他传播。由于有限标本中缺乏遗传物质，梅毒分子分型无法进行。眼部梅毒病例群中常见的异性伴侣以前没有记录过，这表明可能有一种未识别的梅毒螺旋体菌株与梅毒全身表现的风险增加有关。高度的临床怀疑和彻底的性病史对于诊断眼部梅毒、耳部梅毒和神经梅毒至关重要。疾病监测与疾病干预专家调查和治疗转介的协调可以中断梅毒传播。
