55例先天梅毒临床特点与误诊

Clinical analysis of congenital syphilis:55 cases report

目的：探讨先天性梅毒（Congenital syphilis,CS）的临床表现及特征,达到早发现早治疗,减少误诊。方法：1999-2008年间,55例住院患儿,年龄半小时到3岁,确诊为梅毒。分析临床表现与特征。结果：男性33例,女22例。人数逐年增加。55例中仅5例以梅毒感染收入院,50例入院首诊未考虑梅毒。临床表现不典型,可累及多系统,表现为皮肤粘膜损害、黄疸、肝脾大、呼吸急促、骨髓炎、鼻塞鼻涕鼻血丝、呕吐、水肿和抽搐等。结论：CS临床表现多不典型,很易误诊,可出现多系统表现。

Objective：To find out the clinic characteristics of congenital syphilis（CS）,to reduce the possibility of misdiagnosis.Methods：Fifty-five（aged at hedyanhour to three years）cases were analyzed the clinic manifestation retrospectively during 1999 to 2008.Results：There were 33 male and 22 female.of 55 cases,only 5 were diagnosed as CS at the beginning of entry hospital and the rest were misdiagnosed.The main complain showed 27 cases with mucocutaneous lesion（papula,papulopustule,bleb,desquamation）,26 with jaundice,32 with hepatomegaly,14 with splenomegaly,12 with tachypnea,6 with osteomyolitis,20 with nose problem（rhinocleisis, epistaxis,rhinorrhea）,7 with congenital deformity,5 with hemorrhage,4 with abdominal distension,1 with abdominal pain,2 with vomiting,2 with edema,1 with tic,1 with bad cry.Conclusion：In most newborns and infants,the onset of CP is heralded by nonspecific signs which involved multi-system.The rate of misdiagnosed for CP could be beyond 90%.