Analysis Of Clinical Data Of Inpatients With Neurosyphilis

Objective:This paper collected clinical data of hospitalized patients diagnosed with neurosyphilis,including general conditions,clinical features,laboratory examination and imaging features,etc.The data obtained were statistically analyzed and followed up,and the experience and deficiency in diagnosis and treatment were found.Suggestions and measures are put forward to improve the rate of diagnosis,cure and misdiagnosis.Further strengthen prevention,monitoring and treatment.Methods:Through the information system of his in the affiliated hospital of Qingdao university,Shanghai lianzhong hospital's digital medical record retrieval system in the medical record room,and donghua electronic medical record filing management system.Patients diagnosed with neurosyphilis in the department of dermatology and department of neurology in the affiliated hospital of Qingdao university were selected from January 2008 to December 2019.Some patients were followed up to collect data and conduct analysis.Results:Among the 43 patients with neurosyphilis,27 were male and 16 were female,the youngest was 19 years old,the highest was 81 years old,and the average age was50.88±11.70 years old.There were 9 cases of previous syphilis infection,5 cases of married patients had a spouse with a history of syphilis infection,and 2 cases admitted unsafe contact.There were 9 cases of asymptomatic neurosyphilis,15 cases of meningeal vascular neurosyphilis were Partial body sensory disorder,facial nerve paralysis,some patients with positive pathological signs,4cases of meningeal syphilis,Sudden headache,low fever or nausea,vomiting are common,11cases of paralytic dementia type,with Mental decline,work ability decline,abnormal consciousness,emotional instability,etc.4cases of tabes dorsalis type,with mainly manifested as the balance disorder(also known as limb ataxia)of the limbs to complete various movements,the vibration sense of both lower limbs is decreased,the balance of walking is lost,numbness and weakness of both lower limbs,and walking is unstable.All the patients were serological TPPA and RPR positive,cerebrospinal fluid TPPA positive,cerebrospinal fluid RPR positive in 37 cases,cerebrospinal fluid RPR negative in 6cases,titers between 1:1-1:32.There were 9 cases of csf-rpr1:1-1:2,23 cases of csf-rpr1:4-1:8,4 cases of csf-rpr1:16,1 case of csf-rpr1:3,There were 21 cases of CSF protein>500mg/l,and 17 cases of CSF WBC more than 10×10~6/l.Among the imaging examinations,31 patients underwent cranial MRI,while 12 refused to be examined.The results of cranial MRI in 31patients were as follows:cerebral atrophy and frontotemporal lobe atrophy in 7 patients;There were 5 cases of maxillary sinusitis and bilateral ethmoid sinusitis.There were 11 cases with different infarcts.Manifestations of meningitis,hydrocephalus in 1 case;Other manifestations:3 cases(such as abnormal signal shadow in radiating coronal region,multiple abnormal signal shadow in occipital lobe,cerebellar softening lesion,etc.);No obvious abnormality was found in 4 cases.Among the 43 patients,32 were treated with penicillin,9with ceftriaxone and 2 with minocycline.Conclusion:Neurosyphilis tends to occur in middle-aged and elderly men,and the most common clinical type is meningeal vascular neurosyphilis.The imaging manifestations of patients with different types of neurosyphilis can be similar without characteristic features.Paralytic dementia is more common with frontotemporal lobe atrophy.Neurosyphilis can be prevented and treated.Timely and correct diagnosis combined with targeted standard treatment has important clinical significance for the prognosis of patients.