简介:AbstractIntroduction:Malignant syphilis (MS) is a rare and severe variant of secondary syphilis that is frequently associated with HIV infection. The clinical impact of HIV and syphilis co-infection is bidirectional, and the presence of MS is associated with acute HIV infection. Clinically, MS is characterized by nodular and ulcerative lesions affecting the trunk and extremities, which are covered with thick crusts. The treatment of choice for MS remains benzathine penicillin G. Herein, we report a case in which MS was the initial presentation of HIV infection.Case presentation:A 35-year-old male patient came with the chief complaint of extensive erythematous nodular rash for the past one month, with notable ulceration on some lesions with annular configuration along with fever and malaise. Based on the abovementioned clinical, laboratory, and histopathologic findings, the patient was diagnosed with MS and HIV. The diagnosis was established based on histopathological examination and syphilis serological testing.Discussion:Cutaneous disorders are a frequent presenting feature of HIV infection. The clinical manifestations of syphilis in immunosuppressed patients are often severe and/or atypical. The patient was then treated with weekly intramuscular administration of 2.4 million units of benzathine penicillin G for 3 weeks and achieved rapid and significant clinical improvement, with no Jarisch-Herxheimer reaction.Conclusion:Co-infection with syphilis and HIV alters the course of both diseases, and most HIV-infected patients with syphilis have typical disease manifestations associated with decreased CD4+ T-cell counts.
简介:AbstractImportance:Bacteremia tuberculosis (TB) is a severe form of extrapulmonary TB. Studies assessing bacteremia TB in children are limited, especially for HIV-negative children.Objective:To explore the detailed clinical features of the bacteremia TB in children under 18 years of age.Methods:We reviewed the clinical records of the patients retrospectively and collected the strains isolated from their blood cultures. We used mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) to characterize the bacterial genotypes and alamarBlue to determine their drug susceptibility profiles. Polymerase chain reactions and DNA sequencing were used to identify drug-resistant mutations.Results:There were 13 pediatric bacteremia TB patients, 10 of whom were diagnosed with Bacillus Calmette–Guérin (BCG) bacteremia TB. Thirteen patients aged from 0.30 to 11.58 years were enrolled, of whom 76.92% were boys. All had fevers before hospitalization, and 76.92% had respiratory symptoms. All had received BCG vaccinations, and 46.15% had adverse post-vaccination reactions. Compared with Mycobacterium tuberculosis, BCG bacteremia was more likely to appear in younger children. Patients with BCG bacteremia had primary immunodeficiency diseases, and lower CD4, IgA, and IgE levels.Interpretation:Bacteremia TB was rapidly fatal in a large proportion of the immunodeficient children. Because classic findings may not be diagnostically specific, a high level of clinical suspicion is required, especially for patients with certain types of immunosuppression. Studies are needed to develop rapid diagnostic tests and to determine the value of empirical therapy in childhood bacteremia TB.
简介:目的了解广西艾滋病(acquiredimmunodenciencysyndrome,AIDS)/结核病(tuberculosis,TB)双重感染影响因素,为针对该人群的健康教育和健康策略的制定提供参考依据。方法对来自广西南宁市第四人民医院AIDS治疗门诊和感染科住院部就诊和住院的人类免疫缺陷病毒(humanimmunodenciencyvirus,HIV)单纯感染者、TB单纯感染者和HIV/TB双重感染者进行面对面问卷调查,并用Logistic回归分析双重感染的影响因素。结果174名被调查对象中,AIDS单纯感染者83人(47.7%),TB单纯感染者56人(32.2%),HIV/TB双重感染者35人(20.1%);与HIV组比较,HIV/TB双重感染和以下因素有关:了解TB免费治疗政策(OR=2.85,95%CI:1.03~7.85)、接受过有关预防AIDS宣教咨询等服务(OR=0.17,95%CI:0.06~0.49);与TB组比较,HIV/TB双重感染和以下因素有关:现居住地在钦州百色或其他地区(OR=3.44,95%CI:1.26—9.42)、仅通过医生、医院咨询服务了解AIDS(OR:3.68,95%CI:1.28~10.56)。结论应加强社会对AIDS和TB的宣教工作和血液的管理,注意把两种疾病联合进行预防。
简介:摘要目的探讨HIV/TB双重感染患者临床诊断方法及意义。方法选取2016年10月至2017年10月我院190例HIV/TB双重感染患者为研究对象,并与同期我院190例未合并HIV的TB患者进行比较,分析不同检查手段的阳性检出率。结果HIV/TB双感染菌患者中,继发性肺结核的发生率最高,占61.58%,其次为淋巴结结核(20.53%),血型播散型肺结核(9.47%)、结核性胸膜炎(23.68%)、肠结核(14.21%)。PPD试验、痰抗酸染色、T-SPOT.TB及痰结核菌培养在HIV/TB及TB患者中的阳性检出率比较无统计学差异(P>0.05),但结核抗体及血沉在HIV/TB及TB患者中的阳性检出率比较存在统计学差异(P<0.05)。结论各种结核病的诊断方法各有优缺,可根据患者自身情况采用联合诊断的方法来提高阳性检出率,对患者早期治疗提供参考。
简介:摘要目的探讨HIV/AIDS病人的手术风险及防护。方法我院近年来共收治并实施妇科手术治疗106例HIV/AIDS病人,规范手术操作程序,精细操作,减少手术损伤,常规应用抗生素预防感染,及时处理并发症。结果一类切口8例,全部一期愈合;二类切口98例,94例一期愈合,4例切口感染,其中1例55天伤口愈合。结论对HIV/AIDS病人采用适当的手术方式治疗,可以取得良好疗效。
简介:摘要目的为了解嘉鱼县HIV/AIDS感染途径与传播方式,指导防治工作。方法对经过WB法确认的HIV/AID逐例进行个案调查,详细询问婚姻状况、婚外性行为史及性伴数、有偿供血史、受血史。对HIV确认阳性者的配偶、子女全部采血,免费检测HIV抗体。结果全县累计有HIV/AIDS52例,其中外地4例,本县47例。在47例感染者中,男24例女23例,最大年龄62岁,最小18岁,20—49岁占87.23%;已婚30人,占63.83%;具有初中文化程度占65.95%;农民占72.34%;经性途径传播占78.72%、经血液途占19.15%、不详占2.13%。结论嘉鱼县HIV/AIDS的传播方式以性接触传播为主。传染源主要是外出打工者,他(她)在外地感染后,将HIV传给他(她)们的配偶和其他的性伴。目前尚未发现母婴传播。