梅毒性脈絡膜視網膜炎－病例報告

Luetic Chorioretinitis-Case Report

蔡顯楊(Hsien-Yang Tsai) ； 沈秉衡(Bing-Herng Shen)

《中華民國眼科醫學會會刊》 29卷2期 (1990/05) Pp. 880-885

https://doi.org/10.30048/ACTASOS.199005.0153

摘要

後天性梅毒是一種由梅毒螺旋體經性接觸傳染的疾病，它的臨床表徵變化多端，以致經常被誤診為其他疾病，因此有“偉大的模倣者”之稱。後天性梅毒的病程又可分為一、二、三、三期。除了經性接觸傳染的後天性梅毒，梅毒螺旋體更可經向母親之胎盤感染胎兒，造成先天性梅毒。無論先天性或後天性梅毒，均可侵犯眼部，造成嚴重之視力障礙。本篇報告兩例梅毒病人，以主訴視力模糊求診，經詳細之眼科學檢查，兩例病人眼底均呈現相同之黃白色小點變化，螢光眼底攝影顯示為脈絡膜視網膜炎。病人之血清學檢查亦呈現陽性梅毒反應。病人後來均接受盤尼西林注射治療，症狀獲得改善。本篇即報告這兩位病人之臨床發現並進一步討論梅毒造成的眼部變化。

並列摘要

Acquired syphilis is one kind of disease caused by Treponema pallid urn and majorly transmitted through sexual contact. Its clinical manifestations are so variable that frequently been misdiagnosed as other diseases and so it was used to be called as ”the great imitator”. Tile clinical course of acquired syphilis can be divided into three stages: primary, secondary and tertiary and it can attack almost all tile organs of the body including eyes. Here we repoited two cases of late secondary stage syphilis with the chief complaint of blurred vision. After thorough ocular examinations, both cases presented subretinal yellow white dots and fluorescein angiography revealed to be chorioretinitis. Serologic tests for syphilis also revealed strong positive reactions. These two patients received benzathine penicillin injection for treatment and got improvement of their ocular changes. For an unknown intraocular inflammation or uveitis, syphilis must be included in the differential diagnosis.

並列關鍵字

Syphilis ； Luetic chorioretinitis ； Serologic test