Arias Mayorga J, del Pozo Pérez M A, Ortiz de Lejarazu R, Eiros Bouza J, Marañón Cabello A
Servicio de Medicina Interna, Hospital Clínico Universitario, Facultad de Medicina, Valladolid.
An Med Interna. 1992 May;9(5):241-5.
We described an 18 old homosexual man who after 5 days developed a neurologic picture associated with Human Immunodeficiency Viruses (HIV) seroconversion. The patient had developed a dissociative psychiatric disorder 6 months before, and after resolution of the acute neurologic disease a mild neuro-psychiatric disorder remained. After mononucleosis-like syndrome of three weeks, the patient developed a meningo-encephalitic process 48 h post admission. He evolved with tonic seizures and twilight state and was admitted into Intensive Care Unit because of epileptic status and deep coma. Evolution was favourable after 72 h of treatment with acyclovir and antiepileptic drugs. Laboratory data showed an inverted T4/T8 ratio and seroconversion to HIV-antibodies and p24-antigen both in serum and CSF. These observations confirm the existence of psychiatric as well neurological alterations in acute HIV infection, and also the significance of p24-antigen and Western-Blot in serum and CSF in showing the seroconversion profile.
我们描述了一名18岁的同性恋男性,他在5天后出现了与人类免疫缺陷病毒(HIV)血清转化相关的神经系统症状。该患者6个月前曾患分离性精神障碍,急性神经系统疾病缓解后仍遗留轻度神经精神障碍。在出现类似单核细胞增多症的综合征三周后,患者入院48小时后发生了脑膜脑炎。他出现了强直性癫痫发作和朦胧状态,因癫痫持续状态和深度昏迷而被收入重症监护病房。使用阿昔洛韦和抗癫痫药物治疗72小时后病情好转。实验室数据显示T4/T8比值倒置,血清和脑脊液中HIV抗体及p24抗原均发生血清转化。这些观察结果证实了急性HIV感染中存在精神和神经方面的改变,以及血清和脑脊液中p24抗原和免疫印迹法在显示血清转化情况方面的意义。