一名感染人类免疫缺陷病毒的男性患慢性梅毒瘤的罕见病例。

A rare case of a chronic syphilitic gumma in a man infected with human immunodeficiency virus.

作者信息

Masege S D, Karstaedt A

机构信息

Ear, Nose and Throat Department/Head and Neck Surgery,Chris Hani Baragwanath Hospital and University of the Witwatersrand,Soweto, Johannesburg,South Africa.

Department of Medicine (Division of Infectious Diseases),Chris Hani Baragwanath Hospital and University of the Witwatersrand,Soweto, Johannesburg,South Africa.

出版信息

J Laryngol Otol. 2014 Jun;128(6):557-60. doi: 10.1017/S0022215114001200. Epub 2014 Jun 9.

DOI:10.1017/S0022215114001200

PMID:24909596

Abstract

OBJECTIVE

This paper reports a rare case of a human immunodeficiency virus infected man with gummatous syphilis of the face.

CASE REPORT

A 39-year-old man presented with an ulcer of the face which had been slowly progressive over the previous 6 years. Examination showed an ulcerative lesion of the midface involving the cheeks, and completely destroying the nose, the upper lip and part of the lower lip. The teeth and gums were exposed. The ulcer had a moist, purulent base with rolled edges. The patient had human immunodeficiency virus, with a cluster of differentiation 4 count of 641 cells per µl. The rapid plasma reagin test titre was 1:1024 and the Treponema pallidum haemagglutination assay result was positive. Biopsy showed non-necrotising granulomata with a negative Warthin-Starry silver stain. There was a dramatic response to treatment with penicillin.

CONCLUSION

This case study is a reminder that syphilis needs to be considered in the differential diagnosis of unusual presentations involving skin and bone.

摘要

目的

本文报告一例罕见的人类免疫缺陷病毒感染男性患面部树胶肿性梅毒的病例。

病例报告

一名39岁男性患者，面部溃疡，在过去6年中呈缓慢进展。检查发现面中部溃疡性病变累及双侧脸颊，完全破坏了鼻子、上唇和部分下唇，牙齿和牙龈外露。溃疡底部湿润、有脓性分泌物，边缘呈卷曲状。该患者感染了人类免疫缺陷病毒，CD4细胞计数为每微升641个细胞。快速血浆反应素试验滴度为1:1024，梅毒螺旋体血凝试验结果为阳性。活检显示非坏死性肉芽肿，Warthin-Starry银染色阴性。青霉素治疗后反应显著。