Yoo Kyung Mo, Joo Eun-Jeong, Yeom Joon-Sup, Chae Seoung-Wan, Lee Shin Yeoung, Han Ki Joong
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
BMC Infect Dis. 2014 Aug 26;14:462. doi: 10.1186/1471-2334-14-462.
Opportunistic infections are relatively rare in early human immunodeficiency virus infection, especially infection with Mycobacterium tuberculosis. Here, we report a patient who presented with acute human immunodeficiency virus and multidrug-resistant M. tuberculosis co-infections.
A 27-year-old homosexual male was admitted for fever, cough, and hepatitis. At the time of admission, the p24 antigen was detected in his serum, indicating that he had an acute human immunodeficiency virus infection. He was also diagnosed with disseminated tuberculosis spreading to the lung and skin. Anti-tuberculosis medication had been started earlier with one-week intervals of highly active antiretroviral therapy. Despite prolonged anti-tuberculosis treatment, the patient developed tuberculous meningitis on the 50th day of admission. Multidrug-resistant tuberculosis was cultured from his sputum and cerebrospinal fluid. The patient was successfully treated with second line anti-tuberculosis medication and antiretroviral treatment.
This is the first case of acute human immunodeficiency virus and multi drug-resistance tuberculosis co-infections. This case indicates that tuberculosis infection should be considered even in patients with acute human immunodeficiency virus infection.
机会性感染在早期人类免疫缺陷病毒感染中相对少见，尤其是结核分枝杆菌感染。在此，我们报告一名同时感染急性人类免疫缺陷病毒和耐多药结核分枝杆菌的患者。
一名27岁的同性恋男性因发热、咳嗽和肝炎入院。入院时，在其血清中检测到p24抗原，表明他患有急性人类免疫缺陷病毒感染。他还被诊断为播散性结核，累及肺部和皮肤。抗结核药物治疗较早开始，同时每隔一周进行高效抗逆转录病毒治疗。尽管进行了长时间的抗结核治疗，但患者在入院第50天发生了结核性脑膜炎。从他的痰液和脑脊液中培养出耐多药结核分枝杆菌。该患者通过二线抗结核药物和抗逆转录病毒治疗成功治愈。
这是首例急性人类免疫缺陷病毒和耐多药结核分枝杆菌合并感染的病例。该病例表明，即使是急性人类免疫缺陷病毒感染患者，也应考虑结核感染。
