以眼部损害为首发症状的神经梅毒10例临床分析

目的探讨以眼部损害为首发症状的神经梅毒的临床特点。方法回顾性分析2011年1月-6月本科诊治的10例以眼部损害为首发症状的神经梅毒患者临床及实验室资料。结果 9例初始表现为视力下降,被误诊为葡萄膜炎、视网膜炎或视神经乳头炎,1例表现为复视。10例患者血清TRUST试验及TPPA和脑脊液VDRL均阳性,5例脑脊液蛋白或白细胞明显升高。结论梅毒性眼病常合并神经系统感染,临床医生应予以重视。

Clinical Analysis of 10 cases of Neurosyphilis with Ocular Impairment as the Initial Symptom

Objective To study the clinical features of neurosyphilis initiated with ocular impairment. Methods Clinical features and laboratory findings of 10 patients diagnosed from January to June 2011 were analyzed retrospectively. Results The clinical features of 9 patients showed the initial symptom of visual acuity decline. These patients presented with uveitis or retinitis or optic neuritis. The other patient showed diplopia. In all patients, toluidine red unheated serum regain test(TRUST)and treponema pallidum particle agglutination test(TPPA)of serum and venereal disease research laboratory(VDRL)of cerebrospinal fluid(CSF)were positive. A significant increase was observed in CSF leukocyte count or in CSF protein in 5 patients. Conclusion Ocular syphilis usually occured with nervous system infection, but they were hardly reported. So clinicist should pay more attention to it.