咽喉部梅毒5例诊治体会

The diagnosis and treatment of throat syphilis in 5 cases

目的：分析以咽部疼痛、咽部异物感、声音嘶哑为首发症状的咽喉部梅毒的临床特点及诊治体会,以减少误诊、误治。方法：对5例咽喉部梅毒患者的临床资料进行回顾性分析,并复习相关文献。结果：5例患者均有咽部或喉部黏膜白色病损,经甲苯胺红不需加热血清试验和梅毒螺旋体颗粒凝集试验进行梅毒血清学检查均呈阳性。经治疗后症状消失,复查甲苯胺红不需加热血清试验滴度下降。随访0.5-2年,1例复发。结论：咽喉部梅毒的诊治关键在于明确诊断,诊断主要依据接触史、典型临床表现,同时结合实验室检查；当接触史不明确或临床难于确诊时,则依靠相应病原性检查及病理学检查。

Objective：To analyze the clinical features, diagnosis and treatment of throat syphilis with pharyngeal pain, pharyngeal foreign body sensation and hoarseness as the first symptoms for reducing its misdiagnosis and mistreatment. Methods：The clinical data of 5 patients with throat syphilis were retrospectively analyzed,and the related literatures were reviewed. Results：The white lesions in pharyngeal were or laryngeal mucosa of five patients were found, which was positive by the toluidine red unheated serum test and treponema pallidum particle agglutination test. The symptoms were disappeared and the titer of toluidine red unheated serum test were decreased after treatment. All patients were followed up for 0. 5 to 2 years, and only one case recurred. Conclusions：The definite diagnosis is the key of the treatment of throat syphilis, which bases primarily on the patient′s exposure history, typical clinical manifestations and laboratory test. When the exposure history is not clear or definite diagnosis is difficult,the corresponding pathogenic and pathological examination is important.