以神经系统损害为主要表现的钩端螺旋体病误诊研究

Analysis of Misdiagnoses of Leptospirosis Disease CharacterizedMainly by Nervous System Damage

目的 对以神经系统损害为主要表现的钩端螺旋体病 2 2例误诊原因进行分析 ,以期提高早期对本病的确诊率。方法 系统回顾分析了以神经系统损害为主要表现的钩端螺旋体病 2 2例误诊病例的临床资料。结果 在 2 2例误诊病例中 ,误诊为脑梗死 10例 ,短暂性脑缺血发作 2例 ,中枢神经系统感染 7例 ,急性脊髓炎、格林巴利综合征、先天性颅内动脉瘤破裂出血各 1例。结论 表现为神经系统损害的钩端螺旋体病变早期误诊率高 ,误诊原因与钩端螺旋体病表现复杂多变有关 ,也与医务人员认识不足有关 ,提示对于原因不明出现神经系统损害的青壮年患者 ,需警惕钩端螺旋体病感染的可能。

Objective In order to improve the early diagnositic rate of leptospirosis disease.Methods The clinical data of 22 mindiagnosed cases of leptospirosis disease characterized mainly by nervous system damage were reviewed systematically.Result 10 cases were misdiagnosed as cerebral infarction,2 transient cerebral ischemia,7 central nervous system infection,and 1 acute myelitis,1 Guillain Barre syndrome,and 1 hemorrhage of congenital intracranial aneurism.Conclusions Early misdiagnosis of leptospirosis disease characterized mainly by nervous system damage was very common, because its clinical symptoms were complicated and some medical staff didn't pay much attention to it.It was suggested that leptospirosis disease should be considered ,especially when young men suffered from inexplicable nervous system damage.