多形态梅毒疹合并非淋菌性尿道炎1例

患者男,25岁。3月前有不洁性接触史。全身多处起皮疹2月余。临床表现为掌跖红斑,阴茎、阴囊处花环状肉芽肿样斑块,肛周扁平湿疣,腹股沟簇集性褐色丘疹,玫瑰疹等,尿道口可见黄色浆液性分泌物。实验室检查:皮损血清渗出液暗视野显微镜下可见梅毒螺旋体,RPR、TPPA(+),NG(-),CT和UU(+)。予阿奇霉素治疗非淋有效,治疗梅毒无效,改用苄星青霉素后皮损消退,RPR滴度下降。

A Case Study of Rare Multiform Syphilis Combined with Nongonococcus

This article reports a case of secondary syphilis.Patient was a 25-year-old male who had been suffered by a scattered mutiple-eruption for about 2 month after taking a risky sex.Clinical manifestation:Multiform skin lesions,such as palm plantar erythemas,plaques like granuloma annulares in penis and scrotum,flat condylomas in perianus,accumulative brown papules, syphilitic roseola in mguina and so on.There was yellow serous secretion coming from the urethral orifice.Laboratory examination showing:Treponema pallidum could be found in the efflusion coming from the skin lesion.The results of rapid plasma reagin test(RPR),Chlamydia teachomatis(CT),Ureaplasma urealyticum(UU) and the spirochaeta pallida agglutination test(TPPA) were positive.Neisseria gonorrhea(NG) were negative.Azithromycin was effective to curing nongonococcus,but ineffective to curing syphilis.After using benzathine benzylpenicillin,the skin lesions subsided,and the titer of rapid plasma reagin test decreased.