新生儿先天性梅毒尸检1例及文献复习

目的 探讨新生儿先天性梅毒的诊断及临床病理学特征.方法 尸检1例新生儿先天性梅毒,结合文献讨论该病的临床表现、病理形态学特点.结果 新生儿先天性梅毒可侵犯全身任何组织,病理改变主要是多脏器纤维化,以肝、胰、脾等实质器官最明显.部分病例还可见脏器内（如脑）血管壁纤维素样坏死、间质性肺炎等改变,因造成多脏器功能障碍而引起各种症状,甚至死亡.结论 新生儿先天性梅毒的临床表现复杂,临床诊断主要依据病史、各类血清学检测.其病理学改变也较复杂,但有一定的特征性变化.正确的诊断有赖于对可疑患儿的皮疹、胎盘或脐带的渗出物等进行涂片,在暗视野显微镜下用美蓝、嗜银等染色后可检查到梅毒螺旋体.

Neonatal congenital syphilis: an autopsied case report and review of literature

Objective To study the diagnosis and clinicopathological features of congenital syphilis. Methods One patient of congenital syphilis was autopsied and the clinical manifestation, clinicopathological features discussed with review of the related literature. Results Congenital syphilis involved many different organs, especially liver, pancreas and spleen. The main pathological change was fibrosis of the organs. Some eases presented fibfinoid necrosis of vascular well, interstitial pneumonia and other changes, which could lead to multiple organ failure with a variety of symptoms or even to death. Conclusion The elinicopathologieal features and pathological changes of congenital syphilis are very complicated, and the clinical diagnosis depends mainly on history of disease and serum test. Pathological diagnosis bases mainly on the finding of spirochete in exudates of exanthema, placenta, or umbilical cord.