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青年期以精神症状为表现的神经梅毒:一例报告

Neurosyphilis Presenting as Psychiatric Symptoms at Younger Age: A Case Report.

作者信息

Li Hong-Yan, Wang Hao-Yu, Duan Yi-Fei, Gou Yu, Liu Xiao-Qin, Gao Zheng-Xiang

机构信息

West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China.

出版信息

Int Med Case Rep J. 2024 Jul 2;17:647-650. doi: 10.2147/IMCRJ.S477459. eCollection 2024.

Abstract

Neurosyphilis is a central nervous system infection caused by that imitates various neurological and mental disorders. Therefore, patients with this disease are prone to misdiagnoses. Here, we report a case of neurosyphilis with a psychotic disorder as the main manifestation. A young girl exhibited mental and behavioural abnormalities after a heartbreak, which manifested as alternating low mood, emotional irritability, and a lack of interest in social relations, followed by memory loss. The cerebrospinal fluid protein - Treponema pallidum particle agglutination test was positive, the toluidine red unheated serum test titre was 1:4, the white blood cell count was 5 × 10^6/L, the cerebrospinal fluid protein level was 0.97 g/L, and the brain CT was abnormal. After admission, the possibility of neurosyphilis was considered and the patient received intravenous penicillin G treatment. The patient's clinical symptom ms improved. This case emphasises that doctors should maintain clinical suspicion of infection in adolescent patients with mental abnormalities.

摘要

神经梅毒是一种由[病原体未提及]引起的中枢神经系统感染,可模仿各种神经和精神障碍。因此,患有这种疾病的患者容易被误诊。在此,我们报告一例以精神障碍为主要表现的神经梅毒病例。一名年轻女孩在经历失恋后出现精神和行为异常,表现为情绪低落、情绪易怒交替出现,对社会关系缺乏兴趣,随后出现记忆力减退。脑脊液蛋白 - 梅毒螺旋体颗粒凝集试验呈阳性,甲苯胺红不加热血清试验滴度为1:4,白细胞计数为5×10^6/L,脑脊液蛋白水平为0.97g/L,脑部CT异常。入院后,考虑神经梅毒的可能性,患者接受了静脉注射青霉素G治疗。患者的临床症状有所改善。该病例强调,医生应对有精神异常的青少年患者保持对[感染病原体未提及]感染的临床怀疑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cb9/11227323/eb337efd55f0/IMCRJ-17-647-g0001.jpg

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