Thompson L, Schönfeldt A, Salcedo M, Sánchez G, Mollinedo E
Servicio de Urgencia, Clínica Santa María, Santiago, Chile.
Rev Med Chil. 1991 Jan;119(1):56-9.
A 37 year old male developed fever for 20 days, along with headache, anorexia, malaise, sweating, pharyngitis, lymphadenopathy and splenomegaly. At this stage, Ag p24 was positive and anti HIV was negative. The patient recovered fully but 6 months later positive HIV titers were demonstrated by immunofluorescence and Western-blot. A retrospective diagnosis of acute retroviral syndrome was made. The difficult differential diagnosis with infectious mononucleosis, cytomegalovirus, measles, rubella, toxoplasmosis and influenza is discussed. Thus, anti HIV antigenemia should be investigated in any patient with a mononucleosis like syndrome belonging in a high risk group for AIDS, even if Paul-Bunnell-Davidson or IgG anti VCA-EB reactions are positive.
一名37岁男性发热20天，伴有头痛、厌食、乏力、出汗、咽炎、淋巴结病和脾肿大。在此阶段，抗原p24呈阳性，抗HIV呈阴性。患者完全康复，但6个月后免疫荧光和免疫印迹显示HIV滴度呈阳性。做出了急性逆转录病毒综合征的回顾性诊断。讨论了与传染性单核细胞增多症、巨细胞病毒、麻疹、风疹、弓形虫病和流感的鉴别诊断难点。因此，对于任何患有类似单核细胞增多症综合征且属于艾滋病高危人群的患者，即使保罗-邦内尔-戴维森试验或IgG抗VCA-EB反应呈阳性，也应进行抗HIV抗原血症检查。
