Zuretti A R, Schwartz I S
Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai Hospital, New York, New York.
Am J Clin Pathol. 1990 Jun;93(6):828-30. doi: 10.1093/ajcp/93.6.828.
An unusual case of a gangrenous herpetic whitlow is reported. The patient, a 37-year-old man with a ten-year history of intravenous drug abuse, was antibody positive for human immunodeficiency virus. Progressive, extremely painful paronychia of the left third and fourth fingers gradually developed, which persisted despite a variety of treatment protocols, including antibiotics and radiotherapy, ultimately necessitating amputation of the distal portions of the digits. Characteristic herpes-type intranuclear inclusions within epidermal cells were identified in histologic sections of the specimen. Immunohistochemistry using rabbit antihuman herpes virus antibody confirmed the diagnosis. This apparently represents the first documented case of herpetic gangrene in an immunocompromised patient.
报告了一例罕见的坏疽性疱疹性瘭疽病例。患者为一名37岁男性，有10年静脉注射毒品史，人类免疫缺陷病毒抗体呈阳性。左手中指和无名指逐渐出现进行性、剧痛性甲沟炎，尽管采用了包括抗生素和放疗在内的多种治疗方案，病情仍持续，最终不得不截除手指远端部分。在标本的组织学切片中发现表皮细胞内有特征性的疱疹型核内包涵体。使用兔抗人疱疹病毒抗体的免疫组化证实了诊断。这显然是免疫功能低下患者中首例有文献记载的疱疹性坏疽病例。
