24例早期梅毒被误诊临床分析

Clinical analysis of 24 misdiagnosed cases of early syphilis

目的了解早期梅毒误诊情况,探讨误诊原因。方法对误诊的24例早期梅毒进行临床分析,并进行梅毒血清学检查。结果一期梅毒易误诊为软下疳、生殖器疱疹、脓皮病等,女性还易误诊为急性女阴溃疡;二期梅毒斑疹及斑丘疹皮损易误诊为过敏性皮炎、玫瑰糠疹等;鳞屑性丘疹易误诊为银屑病;扁平湿疣易误诊为尖锐湿疣等。结论对早期梅毒采用暗视野梅毒螺旋体(TP)检查和快速血浆反应素环状卡片试验(PPR),可提高诊断质量,降低误诊几率。

Objective To study the cause of misdiagnosis of early spyhilis.Methods 24 misdiagnosed cases of early syphilis were analyzed,and were performed with syphilis serology examination.Results Primary syphilis was found to be commonly misdiagnosed as chancroid,genital herpes,and pyoderma,and misdiagnosed as ulcer vulvae in females.For secondary syphilis,macular syphilide and maculopapular syphilide were easily misdiagnosed as dermatitis or pityriasis rosea;papulosquamous syphilide as psoriasis vulgaris,and condyloma latum as condyloma acuminatum.Conclusion Early syphilis was performed with dark-field microscopy trepanema pallidum and rapid plasma regain circle card test,can increase diagnosis quanlity,lower diagnostic errors.