Dull J S, Sen P, Raffanti S, Middleton J R
Raritan Bay Medical Center, Perth Amboy, NJ.
South Med J. 1991 Jun;84(6):733-5, 739. doi: 10.1097/00007611-199106000-00014.
All reported clinical characteristics of acute retroviral illness with the human immunodeficiency virus (HIV) are nonspecific. Signs and symptoms described are associated with a variety of acute infections. We report the cases of three patients in whom the acute retroviral illness was characterized by transient oral candidiasis and unexplained high lactate dehydrogenase values, with or without transient pulmonary infiltrate, in the context of an acute febrile illness. The clinical findings correlated with a severe reduction in the number of CD4 cells. We believe that thrush could be a marker of acute retroviral infection, as it is not a feature of any other heterophil-negative mononucleosis-like syndrome. We propose that in any patient having transient thrush and acute viral syndrome, the possibility of HIV infection should be aggressively pursued serologically, regardless of the patient's HIV risk status, provided that the usual causes of candidiasis (eg, diabetes mellitus, antibiotic use, and dentures) can be excluded.
所有报告的人类免疫缺陷病毒（HIV）急性逆转录病毒疾病的临床特征均不具有特异性。所描述的体征和症状与多种急性感染有关。我们报告了三例患者的病例，在急性发热性疾病背景下，这些患者的急性逆转录病毒疾病的特征为短暂性口腔念珠菌病和不明原因的高乳酸脱氢酶值，伴有或不伴有短暂性肺部浸润。临床发现与CD4细胞数量的严重减少相关。我们认为鹅口疮可能是急性逆转录病毒感染的一个标志，因为它不是任何其他嗜异性抗体阴性单核细胞增多症样综合征的特征。我们建议，对于任何患有短暂性鹅口疮和急性病毒综合征的患者，无论其HIV风险状况如何，只要能排除念珠菌病的常见病因（如糖尿病、使用抗生素和佩戴假牙），都应积极进行血清学检查以排查HIV感染的可能性。
