老年人梅毒性脉络膜视网膜炎一例
A Case of Syphilitic Chorioretinitis in Older Adult
DOI: 10.12677/ACM.2021.114288, PDF,   
作者: 黄玉仪, 余国成, 刘 洁, 孟 晶：暨南大学附属第一医院眼科，广东 广州；刘丽敏：深圳市龙华区中心医院，广东 深圳
关键词: 梅毒性脉络膜视网膜炎；病例报告；假阴性；Syphilitic Chorioretinitis； Case Report； False-Negative
摘要: 老年人常被设定为梅毒的低风险群体，导致漏诊的发生，在缺乏典型症状和检验结果错误的老年患者身上，更是不可避免地出现误诊。本文报道了1例76岁的男性，以视网膜脉络膜炎为梅毒首发症状，且非特异性梅毒抗体试验为假阴性的病例。分析了老年人梅毒的特点及梅毒假阴性的原因。提示，应重视老年人梅毒，才能避免漏诊，并且在缺乏典型症状和检验结果错误的老年患者身上仍能做出正确诊断。
Abstract: The elderly patients are often been set as a low-risk group for syphilis, which always lead to missed diagnosis. In atypical cases and cases with wrong test results, misdiagnosis is almost inevitable. We reported a 76-year-old man with syphilitic chorioretinitis as the initial presentation of syphilis, and his non-treponemal tests (NTT) was false-negative. Through analyzing the characteristics of syphilis in the elderly people and the causes of false negative in syphilis, we emphasize the importance of paying attention to syphilis in the elderly. Only when we have enough awareness of syphilis in elderly patients, can we diagnose syphilis on the older adults, the atypical cases and cases with wrong test results.
文章引用：黄玉仪, 刘丽敏, 余国成, 刘洁, 孟晶. 老年人梅毒性脉络膜视网膜炎一例[J]. 临床医学进展, 2021, 11(4): 1998-2002. https://doi.org/10.12677/ACM.2021.114288

参考文献

[1] Maves, R.C., Cachay, E.R., Young, M.A. and Fierer, J. (2008) Secondary Syphilis with Ocular Manifestations in Older Adults. Clinical Infectious Diseases, 46, e142-145. [Google Scholar] [CrossRef] [PubMed]
[2] 汤少开, 杨韵青, 钟雪莲, 何婉苹, 罗权, 叶兴东, 朱慧兰, 王建琴. 2010-2019年广州市梅毒流行特征分析[J]. 现代预防医学, 2020, 47(18): 3297-3299+3303.
[3] Johnson, B.K. (2013) Sexually Transmitted Infections and Older Adults. Journal of Gerontological Nursing, 39, 53-60. [Google Scholar] [CrossRef] [PubMed]
[4] Chen, L., His, J.H., Wu, X., Shen, Z., Lu, H., Chen, H., Huang, H., Zhang, H., Ruan, Y., Shao, Y. and Tang, Z. (2017) Disparities in HIV and Syphilis Prevalence and Risk Factors between Older Male Clients with and without Steady Sex Partners in Southwestern Rural China. BMC Infectious Diseases, 17, 269. [Google Scholar] [CrossRef] [PubMed]
[5] Hook 3rd, E.W. (2017) Syphilis. Lancet, 389, 1550-1557. [Google Scholar] [CrossRef] 
[6] 王林娜, 郑和义, 左亚刚, 等. 50例老年梅毒的回顾性分析[J]. 中国医学科学院学报, 2014, 36(2): 198-200.
[7] Hong, M.C., Sheu, S.J., Wu, T.T. and Chuang, C.T. (2007) Ocular Uveitis as the Initial Presentation of Syphilis. Journal of the Chinese Medical Association, 70, 274-280. [Google Scholar] [CrossRef] 
[8] Martins, C.J., Lima, R.B., Eyer-Silva, W.A., Almenara, C.B., Carvalho-Rangel, I., Carvalho, R.S., Basílio-de-Oliveira, R.P., Araujo, L.F., Ferry, F.R.A. and Silva, L.R.D. (2020) Secondary Syphilis Presenting as Syphilide psoriasiforme: Lessons from the Older Syphilology Literature. Revista do Instituto de Medicina Tropical de São Paulo, 62, e21. [Google Scholar] [CrossRef] [PubMed]
[9] Morshed, M.G. (2014) Current Trend on Syphilis Diagnosis: Issues and Challenges. Advances in Experimental Medicine and Biology, 808, 51-64. [Google Scholar] [CrossRef] [PubMed]
[10] Liu, L.L., Lin, L.R., Tong, M.L., Zhang, H.L., Huang, S.J., Chen, Y.Y., Guo, X.J., Xi, Y., Liu, L., Chen, F.Y., Zhang, Y.F., Zhang, Q. and Yang, T.C. (2014) Incidence and Risk Factors for the Prozone Phenomenon in Serologic Testing for Syphilis in a Large Cohort. Clinical Infectious Diseases, 59, 384-389. [Google Scholar] [CrossRef] [PubMed]
[11] Oliver, G.F., Stathis, R.M., Furtado, J.M., Arantes, T.E., McCluskey, P.J. and Matthews, J.M. (2019) International Ocular Syphilis Study Group, Smith JR. Current Ophthalmology Practice Patterns for Syphilitic Uveitis. British Journal of Ophthalmology, 103, 1645-1649. [Google Scholar] [CrossRef] [PubMed]
[12] Singh, A.E. (2020) Ocular and Neurosyphilis: Epidemiology and Approach to Management. Current Opinion in Infectious Diseases, 33, 66-72. [Google Scholar] [CrossRef] 
[13] Peeling, R.W., Mabey, D., Kamb, M.L., Chen, X.S., Radolf, J.D. and Benzaken, A.S. (2017) Syphilis. Nature Reviews Disease Primers, 3, 17073. [Google Scholar] [CrossRef] [PubMed]
[14] Hoogewoud, F., Frumholtz, L., Loubet, P., Charlier, C., Blanche, P., Lebeaux, D., Benhaddou, N., Sedira, N., Coutte, L., Vanhaecke, C., Launay, O., Le Jeunne, C., Héron, E., Monnet, D., Lortholary, O., Sahel, J.-A., Dupin, N., Brézin, A., Errera, M.-H., Salah, S. and Groh, M. (2017) Prognostic Factors in Syphilitic Uveitis. Ophthalmology, 124, 1808-1816. [Google Scholar] [CrossRef] [PubMed]

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