以精神症状为主的神经梅毒合并脑积水1例报告及文献复习

Report of a Case of Neurosyphilis Accompanied with Hydrocephalus Taking Psychiatric symptoms as Dominant Clinical Manifestation and Literature Review

目的探讨神经梅毒的临床特征、早期诊断及治疗。方法回顾性分析经临床和实验室检查确诊的1例神经梅毒患者的临床资料及查阅相关文献。结果这例病人经抗梅毒及脑室-腹腔分流术治疗后,临床症状明显改善。神经梅毒主要分为5种类型,临床表现多样。目前其诊断主要依靠流行病史、临床表现以及实验室检查结果的综合判断。结论神经梅毒误诊率高,临床表现、实验室及影像学检查是其诊断的重要依据。对于合并脑积水的病例,可在病情稳定后行分流术。

Objective To explore the clinical characteristics, the early diagnosis and treatment in the patient with neurosyphilis. Methods The clinical data of 1 patient with neurosyphilis definitely diagnosed as by clinical and laboratory examination were analyzed retrospectively. The review of the literature related to neurosyphilis was performed. Results The patient was significantly improved in the clinical symptoms after he was treated by antisyphi]itics and ventriculo-peritoneal shunt. Neurosyphilis had five major types, and the clinical manifestations of neurosyphilis were varied, The diagnosis of neurosyphilis mainly depended on its epidemiology, clinical characteristics and the laboratory examinations. Conclusions Once neurosyphilis is definitely diagnosed as it should be antisyphilitically treated. The ventriculo-peritoneal shunt should be performed in the patients with neurosyphilis accompanied with Hydrocephalus when the patient is in a stable condition.