男同性戀合併二期梅毒：一病例報告並著重於男同性戀之照護

A Gay Man with Secondary Syphilis: Report of a Case with Special Emphasis on the Care of Men who have Sex with Men

世界衛生組織估計全球每年約有新增壹千兩百萬例梅毒個案，台灣每年梅毒通報個案也在不斷增加中。從西元2000年至2008年，台灣梅毒通報個案由3838例增加至6526例。在某些高危險族群，就如男同性戀，其發生率更有快速增加趨勢。依不同地域，其比率可達8.1-13.8%。性別相關醫學目前已是畢業前（後）一般醫學訓練和醫師繼續教育的核心課程之一。 我們如何將其精神與內涵融入日常行醫當中？在此我們提出一位男同性戀合併二期梅毒的個案，探討其血清學診斷，接受腰椎穿刺適應症，藥物治療處方，合理的追蹤期和如何去除MSM污名化並提供全人照護。

The World Health Organization estimates that, annually, there are 12 million new cases of syphilis worldwide. The number of cases reported in Taiwan is on the rise; from 2000 through 2008, the number of annually reported cases of syphilis in Taiwan has increased from 3838 to 6526. The incidence of syphilis has increased even more in certain at-risk populations, such as men who have sex with men (MSM) with rates around 8.1-13.8%, depending on the city. Gender-related medicine has been part of the core curriculum in undergraduate, postgraduate and continuing medical education programs. We must integrate gender issues into daily clinical practice. We present the case of a gay man with secondary syphilis and discuss the serologic diagnosis of syphilis, when to perform lumbar puncture, a treatment regimen, reasonable follow-up periods, and how to eliminate stigmatization and implement holistic health care for men who have sex with men.