Acharya Vasudeva, Varghese George K, Roy Alfred
Department of Medicine, Kasturba Medical College, Manipal 576104.
J Indian Med Assoc. 2011 Mar;109(3):196-7.
Atypical features of secondary syphilis are more common in patients with human immunodeficiency virus infection. We report this case in which the clinical features, serology and response to therapy were clearly suggestive of secondary syphilis but histopathology raised concerns about cutaneous lymphoma. A 30-year-old male presented with history of fever and cough of one month duration. He was seropositive for human immunodeficiency virus infection one year back. He had discrete multiple papular and papulonodular patches all over the body. VDRL and TPHA tests were positive. HIV infection was confirmed by two ELISA tests. Skin biopsy report raised the possibility of lymphomatous infiltration. He was treated with penicillin and responded favourably. He was also instituted antiretroviral therapy later.
二期梅毒的非典型特征在人类免疫缺陷病毒感染患者中更为常见。我们报告了这例病例，其临床特征、血清学及治疗反应均明确提示为二期梅毒，但组织病理学结果引发了对皮肤淋巴瘤的担忧。一名30岁男性，有持续1个月的发热和咳嗽病史。他在1年前人类免疫缺陷病毒感染血清学检测呈阳性。全身有散在多发的丘疹及丘疹结节性斑块。性病研究实验室试验（VDRL）和梅毒螺旋体血凝试验（TPHA）均为阳性。通过两次酶联免疫吸附测定（ELISA）试验确诊为HIV感染。皮肤活检报告提示有淋巴瘤浸润的可能。他接受了青霉素治疗，反应良好。之后他也开始接受抗逆转录病毒治疗。
