Second Stage Syphilis Condyloma With Nervous System Damage-1 Cases Report And Literature Review

Objective:Report 1 case of rare neurosyphilis, Second stage syphilis condyloma with nervous system damage, in order to improve the dermatologist clinician awareness of the disease, reduce misdiagnosis.Methods:Analysis of the clinical data of 1 cases and review of related literature two period syphilis flat condyloma merge neurosyphilis.Results:The patients with perianal pale red flat papules, sessile, leaflike fusion component as the main clinical manifestations. Serum TRUST (+): qualitative, quantitative TRUST 1:32 TPPA (+), qualitative. Cerebrospinal fluid: TRUST (-), TPPA (+); qualitative CSF routine:Pan’s reaction (+), the number of nucleated cells of 11.6* 106/L, mainly lymphocytes, CSF biochemistry:protein 554.3mg/L. Perianal rash pathology:HPV (-); skin was papillomatosis; among prickle cells edema, scattered infiltration in neutrophils; superficial dermal vessels around the lymphoid tissue cells, the majority of plasma cells, and neutrophils infiltration; no hollow cells. Condyloma flat surface secretions and serum papilloma virus HPV type (-). Combined with the clinical manifestations, pathological and laboratory examination, and consults the related literature analysis, diagnosis of two period syphilis flat condyloma merge neurosyphilis was established.Conclusions:Condyloma belongs to the second stage of syphilis rash, is papular syphilid, special types of the rash as sometimes it is not easy and acuteness wet wart to identify, especially in the crissal condyloma are often inexperienced ano-genital warts doctor misdiagnosed as. For cases not easy to identify, should be detailed history, careful analysis whether her lesions form and with other syphilid, and syphilis serology test, pathological biopsy can also assist in diagnosis. Neurosyphilis complex and varied clinical manifestations, high misdiagnosis and missed diagnosis, clinical diagnosis should be combined with clinical characteristics, test positive for syphilis serology, cerebrospinal fluid the venereal disease research experiment CSF VDRL positive or positive cerebrospinal fluid treponema pallidum gelatin agglutination test (TPPA), check considering influence studies, etc. Neurosyphilis clinical manifestation is diversiform, can easily lead to misdiagnosis. Large dose penicillin treatment curative effect is distinct, foot treatment.