中华皮肤科杂志 ›› 2012, Vol. 45 ›› Issue (4): 291-292.

• 病例报告 • 上一篇    下一篇

合并艾滋病的恶性梅毒一例

王虹1,王旭2,付爱华3,于艳3,李珊山4   

  1. 1. 吉林大学白求恩第一医院
    2. 长春市传染病院
    3. 吉林大学第一医院
    4. 长春市吉林大学第一医院皮肤科
  • 收稿日期:2011-05-25 修回日期:2011-06-18 出版日期:2012-04-15 发布日期:2012-03-30
  • 通讯作者: 王虹 E-mail:wanghong63@sina.com

A case of lues maligna complicated by acquired immunodeficiency syndrome

  • Received:2011-05-25 Revised:2011-06-18 Online:2012-04-15 Published:2012-03-30
  • Contact: WANG Hong E-mail:wanghong63@sina.com

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摘要：

【摘 要】 目的 报告1例以恶性梅毒为首发的艾滋病；探讨恶性梅毒的临床表现、诊断标准及治疗。方法：以恶性梅毒为首发的艾滋病病例报告并文献回顾。结论 根据血清学TPPA（+）、RPR 1:32（+）；严重的吉海氏反应及毒血症症状；特征性结节-溃疡性皮损表现及组织病理学改变；青霉素治疗反应良好；HIV抗体初筛及确诊试验阳性，血CD4+细胞数为136/ul, CD4+/CD8+为0.18，患者诊断为恶性梅毒、HIV感染-艾滋病期。对于合并艾滋病的梅毒患者推荐采用神经性梅毒的治疗方案同时给予HARRT抗HIV治疗。

关键词: 艾滋病

Abstract:

[Abstract] Objective To report a case of lues maligna as the first manifestation of AIDS and emphasize the clinical manifestations, diagnostic criteria and management of lues maligna. Methods Case report of lues maligna as the first manifestation of AIDS and review of the literature. Conclusions Based on serology TPPA(+)/RPR1:32(+), a severe Jarisch- Herxheimer reaction and Toxemia , skin lesions features characterized by nodulo-ulcerative form and pathological findings; excellent response to antibiotic therapy ; a positive serology for both HIV (ELISA and Western-Blot), CD4+ cell count 136/ul , CD4+/CD8+ 0.18, The diagnosis was made of lues maligna and AIDS. Recommended regimen for lues maligna in AIDS was neurosyphilis therapy and HARRT.

Key words: AIDS