神经梅毒21例误诊分析

Clinical analysis of 21 cases with neurosyphilis

目的探讨神经梅毒的误诊原因,减少误诊。方法回顾性分析经临床和实验室确诊的39例神经梅毒病人的临床资料。结果有21例误诊。其中,5例被误诊为脑卒中,4例被误诊为结核性脑膜炎,5例被误诊为颈椎病、脊髓压迫症、急性脊髓炎、脊髓血管病,2例被误诊为视神经炎,1例被误诊为癫痫,1例被误诊为偏头痛,1例被误诊为附睾炎,1例被误诊为精神分裂症,1例被误诊为老年性痴呆。结论神经梅毒临床表现复杂多样,加强重视,全面查体,对疑似病例进行相关实验室检查,以减少误诊。

Objective To explore the misdiagnostie cause of neurosyphilis and to reduce misdiagnestie level. Methods The clinical data of 39 eases with neurosyphilis diagnosed by clinic and laboratory were analyzed restospeetively. Results Among misdiagnostie 21 eases, 5 eases were misdiagnosed as stroke, 4 eases were misdiagnosed as tuberculous meningitis, 5 eases were misdiagnosed as cevial spondylosis, myelitis, compressive myelopathy and vascular diseases of the spinal cord, 2 eases were misdiagnosed as optic neuritis, 1 ease was misdiagnosed as epilepsy, 1 ease was misdiagnosed as migraine, I case were misdiagnosed as epididymitis, 1 ease was misdiagnosed as schizophrenia and 1 ease was misdiagnosed as dementia. Conclusions The clinical diversity of neurosyphilis. Was characteristic. All-out physical examination should be attached importance to. Laboratory test should be implemented to suspected case to reduce diagnostic errors.