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NEJM:继发性梅毒-病例报道

2020-10-01 MedSci原创 MedSci原创

荧光性视网膜蛋白抗体吸收测试具有反应性。人类免疫缺陷病毒测试为阴性。诊断为继发性梅毒。原发感染可能无症状;最初的无痛下疳可能不会引起注意。

患者为一名62岁的男子,因全身无力和弥漫性皮疹2周而到急诊就诊。

经检查,他的体温为38.1°C。体格检查发现他的手掌(如图A所示)、脚底(如图B所示)和躯干(如图C所示)出现斑丘疹,色素沉着和鳞屑疹。生殖器上也有色素沉着斑块。他有与多个伴侣无保护性交史,但没有生殖器下疳或溃疡。

该患者进行了快速血浆反应素测试,结果显示滴度为1:128。荧光性视网膜蛋白抗体吸收测试具有反应性。人类免疫缺陷病毒测试为阴性。诊断为继发性梅毒。原发感染可能无症状;最初的无痛下疳可能不会引起注意。

该患者接受了肌内青霉素G苄星胺治疗,随访3个月后皮疹完全消退,血浆快速滴度降低至1:32。

原始出处:

Priyanka Bhugra,et al.Secondary Syphilis.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm2001103

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    2021-01-30 xzw113
  2. [GetPortalCommentsPageByObjectIdResponse(id=1952696, encodeId=a3611952696b3, content=<a href='/topic/show?id=a37ce8961a1' target=_blank style='color:#2F92EE;'>#继发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78961, encryptionId=a37ce8961a1, topicName=继发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Sat Jan 30 23:16:35 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724527, encodeId=72051e2452760, content=<a href='/topic/show?id=78ece8958b2' target=_blank style='color:#2F92EE;'>#继发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78958, encryptionId=78ece8958b2, topicName=继发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=499d33645837, createdName=feifers, createdTime=Fri Dec 25 20:16:35 CST 2020, time=2020-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035436, encodeId=81fa103543652, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Oct 01 22:16:35 CST 2020, time=2020-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889608, encodeId=7de8889608ae, content=厉害厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpJVcpECMUATt5iaMc09c4WsFcnLwnayPsFkPE92Gibj9T6rMfhSvaZhnjV8SeXr6Bcl4ddfC4m9Cg/132, createdBy=7d5c2384333, createdName=kulou0314, createdTime=Thu Oct 01 20:29:54 CST 2020, time=2020-10-01, status=1, ipAttribution=)]
    2020-12-25 feifers
  3. [GetPortalCommentsPageByObjectIdResponse(id=1952696, encodeId=a3611952696b3, content=<a href='/topic/show?id=a37ce8961a1' target=_blank style='color:#2F92EE;'>#继发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78961, encryptionId=a37ce8961a1, topicName=继发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Sat Jan 30 23:16:35 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724527, encodeId=72051e2452760, content=<a href='/topic/show?id=78ece8958b2' target=_blank style='color:#2F92EE;'>#继发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78958, encryptionId=78ece8958b2, topicName=继发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=499d33645837, createdName=feifers, createdTime=Fri Dec 25 20:16:35 CST 2020, time=2020-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035436, encodeId=81fa103543652, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Oct 01 22:16:35 CST 2020, time=2020-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889608, encodeId=7de8889608ae, content=厉害厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpJVcpECMUATt5iaMc09c4WsFcnLwnayPsFkPE92Gibj9T6rMfhSvaZhnjV8SeXr6Bcl4ddfC4m9Cg/132, createdBy=7d5c2384333, createdName=kulou0314, createdTime=Thu Oct 01 20:29:54 CST 2020, time=2020-10-01, status=1, ipAttribution=)]
    2020-10-01 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1952696, encodeId=a3611952696b3, content=<a href='/topic/show?id=a37ce8961a1' target=_blank style='color:#2F92EE;'>#继发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78961, encryptionId=a37ce8961a1, topicName=继发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Sat Jan 30 23:16:35 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724527, encodeId=72051e2452760, content=<a href='/topic/show?id=78ece8958b2' target=_blank style='color:#2F92EE;'>#继发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78958, encryptionId=78ece8958b2, topicName=继发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=499d33645837, createdName=feifers, createdTime=Fri Dec 25 20:16:35 CST 2020, time=2020-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035436, encodeId=81fa103543652, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Oct 01 22:16:35 CST 2020, time=2020-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889608, encodeId=7de8889608ae, content=厉害厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpJVcpECMUATt5iaMc09c4WsFcnLwnayPsFkPE92Gibj9T6rMfhSvaZhnjV8SeXr6Bcl4ddfC4m9Cg/132, createdBy=7d5c2384333, createdName=kulou0314, createdTime=Thu Oct 01 20:29:54 CST 2020, time=2020-10-01, status=1, ipAttribution=)]
    2020-10-01 kulou0314

    厉害厉害

    0

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