仅表现为反复双下肢疼痛的神经梅毒病例报道1例及文献复习  

A case report and literature review about neurosyphilis with repeated pain in both lower extremities

作　　者：卞鑫 马晶晶 王琳琳 BIAN Xin;MA Jing-jing;WANG Lin-lin(Department of Neurology,Kongjiang Hospital of Yangpu District in Shanghai City,Shanghai 200093,China;Department of Clinical Laboratory,Kongjiang Hospital of Yangpu District in Shanghai City,Shanghai 200093,China)

机构地区：[1]上海市杨浦区控江医院神经内科,上海200093 [2]上海市杨浦区控江医院检验科,上海200093

出　　处：《中国当代医药》2019年第30期171-173,180,共4页China Modern Medicine

基　　金：上海市杨浦区科学技术委员会和杨浦区卫生和计划生育委员会科研课题（YP18M15）

摘　　要：神经梅毒是由于苍白密螺旋体感染中枢神经系统所导致的疾病,脊髓痨是其中一种类型。由于其临床少见且很多患者缺少典型的临床症状和体征,再加上医生认识不足,故临床上常发生误诊或漏诊。本文通过回顾性分析1例仅表现为反复双下肢疼痛无明显阳性体征的中年男性患者,就诊4年余,期间多次误诊误治,最终经脑脊液检查确诊为神经梅毒(脊髓痨型),同时结合国内外相关文献进行复习,探讨神经梅毒的临床特征、发病机制、诊断和治疗的特点与规律,以期降低临床误诊率。Neurosyphilis is an infective disease of central nervous system caused by the pale treponema pallidum,Tabes dorsalis is one type of it.Due to its clinical rarity and lack of typical symptoms and signs in many patients,and insufficient understanding by doctors,misdiagnosis or missed diagnosis often occurs in clinical practice.This paper retrospectively analyzed a case of a middle-aged male patient who had recurrent lower extremity pain and no obvious positive signs for more than four years,during which many misdiagnoses and mistreatments were made.Finally,he was diagnosed with neurosyphilis(tabes dorsalis type)by cerebrospinal fluid examination.By combining this case with relevant literature review at home and abroad,the clinical characteristics,pathogenesis,characteristics and rules of diagnosis and treatment of neurosyphilis were discussed in this paper,so as to reduce the rate of misdiagnosis.

关 键 词：神经梅毒 脊髓痨 闪电样疼痛 临床特点 性病研究实验室试验 误诊 脑脊液 文献复习 

分 类 号：R759.13[医药卫生—皮肤病学与性病学]