del Rio C, Soffer O, Widell J L, Judd R L, Slade B A
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Rev Infect Dis. 1990 Mar-Apr;12(2):282-5. doi: 10.1093/clinids/12.2.282.
A previously healthy 29-year-old homosexual man presented with a 4-day history of fever, malaise, sore throat, and bleeding gums. Rhabdomyolysis, acute renal failure, and nephrotic range proteinuria were also present. The patient was found to have acute human immunodeficiency virus (HIV) infection confirmed by the presence of HIV antigen in his serum and subsequent evolution of an HIV antibody profile typical of acute seroconversion. A kidney biopsy revealed acute tubular necrosis and mesangioproliferative glomerulonephritis, with tubuloreticular inclusions. In the presence of otherwise unexplained acute renal failure, rhabdomyolysis, or new onset nephrotic syndrome, acute HIV infection should be considered in the differential diagnosis.
一名既往健康的29岁同性恋男性，出现发热、乏力、咽痛和牙龈出血4天。同时伴有横纹肌溶解、急性肾衰竭和肾病范围蛋白尿。患者血清中检测到HIV抗原，随后出现典型急性血清转化的HIV抗体谱，确诊为急性人类免疫缺陷病毒（HIV）感染。肾活检显示急性肾小管坏死和系膜增生性肾小球肾炎，并伴有管网状包涵体。在存在无法解释的急性肾衰竭、横纹肌溶解或新发肾病综合征的情况下，鉴别诊断时应考虑急性HIV感染。
