Palamaras Ioulios, Richardson Daniel, Healy Vourneen, Lyons Deirdre, Byrne Micheline, Lamba Harpal
St Mary's Hospital, London W2 1NY, UK.
Int J STD AIDS. 2006 Jun;17(6):427-8. doi: 10.1258/095646206777323508.
A 43-year-old woman from Southern Africa presented with an eight-month history of a painless vulval ulcer. She did not have any relevant past medical or drug history. She had never had, or ever been offered an HIV antibody test despite being from an endemic region. On examination, there was an ulcer on her right labia and a painless right inguinal lymph node. Herpes simplex virus (HSV) type 2 culture was positive. The HIV antibody test was also positive. Other cultures and serology including syphilis were negative. A biopsy was suggestive of herpes simplex. The vulval ulcer resolved on oral aciclovir only. Atypical genital herpes has been described in HIV disease, although it is often painful. This case emphasises the importance of offering an HIV antibody test to patients presenting with atypical genital ulcers. Moreover, it reinforces the paradigm that 'any anogenital ulcer (painful or not) can be herpetic in origin'.
一名来自非洲南部的43岁女性，出现无痛性外阴溃疡8个月。她既往无相关病史及用药史。尽管来自艾滋病流行地区，但她从未进行过HIV抗体检测。检查发现，她右侧阴唇有一处溃疡，右侧腹股沟淋巴结无痛。2型单纯疱疹病毒（HSV）培养呈阳性。HIV抗体检测也呈阳性。包括梅毒在内的其他培养及血清学检查均为阴性。活检提示为单纯疱疹。仅口服阿昔洛韦后，外阴溃疡即愈合。虽然非典型生殖器疱疹在HIV感染中较为常见，但通常伴有疼痛。该病例强调了对出现非典型生殖器溃疡的患者进行HIV抗体检测的重要性。此外，它强化了“任何肛门生殖器溃疡（无论是否疼痛）都可能源于疱疹”这一范例。
