以声嘶为首发症状的喉梅毒8例临床分析

Clinical Analysis on Initial Symptom with Hoarseness in 8 Patients with Laryngeal Syphilis

目的探讨以声嘶为首发症状的喉梅毒的临床特征、诊断和治疗。方法回顾性分析8例喉梅毒患者的临床表现、实验室资料和治疗方法。结果 8例患者均有误诊史,临床表现为声嘶,喉镜检查见粘膜斑、喉部红斑、黏膜丘疹等病变,血RPR与TPPA试验阳性;予头孢曲松治疗后症状好转,RPR滴度降低。结论喉梅毒临床表现复杂多变,早期误诊率高,血清梅毒抗体检查阳性可提示诊断。

Objective To investigate the clinical manifestations, diagnosis and management of laryngeal syphilis with hoarseness as initial symptom. Methods The clinical features, laboratory findings and therapy methods of 8 patients with laryngeal syphilis were analyzed retrospectively. Results All of 8 patients were misdiagnosed. Hoarseness was the main clinical feature. Laryngoscopic examination showed mucous patch, erythema, mucous papula. Rapid plasma reagid circle card test （RPR） and treponema pallidum partical agglutination test （TPPA） of serum of all 8 patients were positive. Symptoms were improved obviously and RPR tite was decreased after the treatment with ceftriaxone. Conlusions Patients with laryngeal syphilis diverse clinical symptom at the beginning of the course, therefore it is misdiagnosed easily at the first visit. Syphilis antibody test in serum is necessory to diagnose the cases.