Cases Margaret, Leduc Charles, Farmer Patricia L, Richardson Susan E, Zoutman Dick E
Department of Internal Medicine, Queen's University, Canada.
Intern Med. 2014;53(21):2539-42. doi: 10.2169/internalmedicine.53.2343. Epub 2014 Nov 1.
Herpes simplex virus has protean manifestations and is an important cause of morbidity in the immunocompromised host. We report a case of recurrent lymphadenopathy and rash in a patient with chronic lymphocytic leukemia. The elusive clinical diagnosis eventually required core biopsy of a lymph node with immunohistochemistry and confirmation by polymerase chain reaction. This case illustrates the challenging clinical and laboratory diagnosis of herpes simplex virus lymphadenitis and the need to maintain a high index of suspicion for infection when treating an immunocompromised patient with unusual and/or persistent symptoms.
单纯疱疹病毒有多种表现形式，是免疫功能低下宿主发病的重要原因。我们报告一例慢性淋巴细胞白血病患者出现复发性淋巴结病和皮疹的病例。难以捉摸的临床诊断最终需要对淋巴结进行核心活检并进行免疫组织化学检查，随后通过聚合酶链反应加以证实。该病例说明了单纯疱疹病毒淋巴结炎在临床和实验室诊断方面的挑战性，以及在治疗有异常和/或持续症状的免疫功能低下患者时，需要对感染保持高度怀疑。
