Dinotta F, De Pasquale R, Nasca M R, Tedeschi A, Micali G
Dermatological Clinic, University of Catania, Polyclinic Hospital University, Catania, Italy.
G Ital Dermatol Venereol. 2009 Apr;144(2):205-9.
Genital herpes, a viral infection caused by Herpes simplex virus (HSV), is the most common cause of genital ulceration. Patients with a severe decrease in cellular immunity, such as patients positive for Human immunodeficiency virus (HIV) infection, are more likely to develop atypical, severe, disseminated and/or chronic HSV infections. On the other hand, there is an increase incidence of HIV detection among patients positive for HSV infection, as genital ulcers represent a potential portal of entry of HIV into the host. A case of a 52-year-old homosexual man with a two-month history of multiple erythematous ulcerative lesions on the perianal area, the buttocks, and the third left finger is presented. According to the clinical history, the clinical findings and the laboratory results, a diagnosis of HSV infection was made and treatment with valaciclovir was started, which led to complete regression of lesions 30 days later. The atypical features of the herpetic lesions, along with a past history of atypical pneumonitis one year prior to our observation, prompted to a diagnosis of concurrent HIV infection, later confirmed by laboratory
Atypical and disseminated HSV infections occur relatively often in HIV+ patients. This article discusses clinical presentation, diagnosis and management of HSV infection in such cases.
生殖器疱疹是由单纯疱疹病毒（HSV）引起的一种病毒感染，是生殖器溃疡最常见的病因。细胞免疫严重降低的患者，如人类免疫缺陷病毒（HIV）感染阳性患者，更易发生非典型、严重、播散性和/或慢性HSV感染。另一方面，HSV感染阳性患者中HIV检测的发生率有所增加，因为生殖器溃疡是HIV进入宿主的潜在入口。本文介绍了一名52岁同性恋男性病例，其肛周区域、臀部和左手无名指有两个月的多发性红斑溃疡性病变病史。根据临床病史、临床表现和实验室检查结果，诊断为HSV感染，并开始使用伐昔洛韦治疗，30天后病变完全消退。疱疹性病变的非典型特征，以及在我们观察前一年有非典型肺炎病史，提示并发HIV感染，后来经实验室检查得以证实。
非典型和播散性HSV感染在HIV阳性患者中相对常见。本文讨论了此类病例中HSV感染的临床表现、诊断和管理。
