NEJM:先天性梅毒-病例报道

2019-11-28 xing.T MedSci原创

在美国,梅毒的发病率不断增加,使对先天性梅毒的认识和预防成为重要的公共卫生问题。

患者为一名6个月大的女孩,其母最近被诊断出梅毒,经检查表明她也患有梅毒,而被转至医院进行评估和治疗。这位母亲在妊娠初期进行快速血浆反应素(RPR)检查结果为阴性,因此在分娩时未进行再次检查。

就诊前十天,父母确诊梅毒,因此,婴儿也接受了检查。RPR检查结果为阳性(滴度为1:512),确诊性荧光螺旋体抗体测试也为阳性。体格检查显示直肠周围肿物(图A所示)。没有皮疹,肝脾肿大,淋巴结肿大或肢体活动受限。



该患儿的直肠周肿块最早在2周龄时被发现,被认为是血管瘤。获得了直肠周围病变的活检标本,螺旋体的免疫染色呈阳性(如图B所示)。右侧胫骨的X线片显示严重的骨膜炎(如图C所示)。对该儿童进行了为期10天的肠外结晶性青霉素治疗,治疗后直肠周围肿块大小减小(如图D所示)。

在美国,梅毒的发病率不断增加,使对先天性梅毒的认识和预防成为重要的公共卫生问题。 

原始出处:

Antonio C. Arrieta,et al.Congenital Syphilis.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1904420

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    2019-11-29 huirong
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    2019-11-28 旺医

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