23例早期梅毒误诊临床分析  

Clinical analysis on 23 misdiagnosed cases of early syphilis

作　　者：郭猛[1] 徐春华[2] 

机构地区：[1]河南省商丘市第一人民医院皮肤性病科,商丘市476100 [2]商丘市疾病预防控制中心

出　　处：《中华实验和临床感染病杂志（电子版）》2010年第4期28-30,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的了解早期梅毒误诊情况,分析误诊原因,提高临床医生对早期梅毒的诊断水平、总结临床经验,从而降低误诊率。方法回顾性分析2005年至2009年本院早期梅毒误诊病例23例,对该组临床误诊的早期梅毒患者进行详细的病史采集、体检和实验室检查并总结分析其误诊原因。结果早期梅毒的皮疹具有多形性,与许多皮肤病症状相似。因此,一期梅毒容易误诊为软下疳、固定性药疹、生殖器疱疹、白塞病(Behcet)等疾病;二期梅毒容易误诊为玫瑰糠疹、股癣、银屑病、扁平苔藓等疾病。结论早期梅毒误诊原因是多方面的,包括各种主客观因素,应针对不同原因采取相应措施。临床医生应加强业务学习,扩大知识面,工作要认真负责,对临床可疑病例,应详细追问病史,并行梅毒血清学检查以确诊,减少本病误诊的发生。Objective To study the causes of early syphilis misdiagnosis and analyze the reasons of misdiagnosis,and improve the diagnosis level of physicians for early syphilis and summarize the clinical experience to reduce the misdiagnosis rate.Methods Total of 23 early syphilis misdiagnosed cases from 2005 to 2009 were analyzed retrospectively.Detailed medical history were collected and physical examination and laboratory tests were carried out for these patients,so as to summarize and analyze the reasons of misdiagnosis.Results The eruptions of early syphilis were multiform,the symptoms were similar to many other skin diseases,therefore,it was misdiagnosed easily.Primary syphilis could be misdiagnosed as chancroid,FDE,genital herpes,Behcet＇s and other diseases.Secondary syphilis could be misdiagnosed as Gibert＇s disease,tinea corporis,psoriasis,lichen planus and other diseases.Conclusions There are many causes for early syphilis misdiagnosis including both objective and subjective factors,so corresponding measures should be directed to take for different reasons.In particularly,clinicians should strengthen learning,expand knowledge,enhance the professional responsibility and should be serious and responsible.In order to reduce the incidence of misdiagnosis of early syphilis,detail medical history and serologic examination are necessary for confirmation of suspicious syphilis cases.

关 键 词：梅毒 误诊 临床分析 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]