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目的探讨神经梅毒合并HIV感染的临床表现及转归。方法对北京地坛医院收治的6例神经梅毒合并HIV感染者的性别、好发人群、临床表现、实验室检查、诊断方法、治疗经过及转归进行回顾性分析。结果 6例神经梅毒合并HIV感染的患者,5例为男性同性恋者。除1例因青霉素过敏而失访外,其他5例患者对青霉素治疗均反应良好。结论男性同性恋人群是梅毒和HIV共感染的高危人群,临床表现多样,可以迅速进展到神经梅毒,且极易被误诊。临床上主要依靠梅毒血清学试验、脑脊液检查、影像学检查和全面细致的查体进行诊断。目前青霉素仍为首选治疗药物。
Objective To investigate the clinical manifestations and prognosis of neurosyphilis combined with HIV infection. Methods Retrospective analysis was made on the sex, the prevalence, clinical manifestations, laboratory tests, diagnosis, treatment, and outcome of 6 cases of neurosyphilis with HIV infection in Beijing Ditan Hospital. Results Six patients with neurosyphilis combined with HIV infection and five patients were male homosexuals. In addition to a case of loss due to penicillin allergy, the other 5 patients responded well to penicillin treatment. Conclusions Male homosexuals are at high risk of syphilis and HIV co-infection. Their clinical manifestations are diverse and can rapidly progress to neurosyphilis and can easily be misdiagnosed. Clinically rely mainly on syphilis serological tests, cerebrospinal fluid examination, imaging studies and detailed examination of the body for diagnosis. Penicillin is still the preferred treatment drug.