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《模仿大师:被遗忘却未消逝》

The Great Mimicker: Forgotten but not Gone.

作者信息

Fenner Blayne E, Burningham Kevin M, Thomas Jamael L, Kelly Brent C, Huen Auris O, Tyring Stephen K

机构信息

Department of Internal Medicine, Dell Medical School University of Texas, Austin, Tex.

Center for Clinical Studies, Webster, Tex.

出版信息

Am J Med Open. 2025 Feb 13;13:100094. doi: 10.1016/j.ajmo.2025.100094. eCollection 2025 Jun.

Abstract

Once subdued after the advent of penicillin, syphilis has re-emerged in recent years, with incidence rates rising in many countries, including the United States. Its reputation as "the great imitator" is well earned due to its widely variable presentation, particularly in its second stage. This contributes to a high rate of delayed diagnosis and misdiagnosis, adding significant burden to patients and the health care system generally. Herein, we present 2 cases in which syphilis was misdiagnosed, leading to unnecessary therapies and delay of symptom clearance until treponemal tests were performed. In the context of recent epidemiologic trends and its notorious difficulty to clinically define, syphilis should always be considered in the differential diagnosis of diffuse cutaneous eruptions.

摘要

自从青霉素问世后梅毒曾一度得到控制,但近年来它又再度出现,在包括美国在内的许多国家发病率都在上升。因其临床表现广泛多样,尤其是在二期梅毒时,它“伟大的模仿者”这一称号可谓名副其实。这导致了很高的漏诊率和误诊率,给患者和整个医疗系统都增加了巨大负担。在此,我们呈现2例梅毒被误诊的病例,这导致了不必要的治疗,且症状在梅毒螺旋体检测完成之前一直未能消除。鉴于近期的流行病学趋势以及梅毒在临床诊断上的 notoriously 困难,在鉴别诊断弥漫性皮肤疹时应始终考虑到梅毒。 (注:原文中notoriously未翻译,因为不确定是否是你输入有误,若有正确内容可补充完整后追问。)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4207/11978317/07331bb3e22c/gr1.jpg

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