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伪装成肌病和横纹肌溶解症的人类免疫缺陷病毒(HIV)

Human Immunodeficiency Virus (HIV) Masquerading as Myopathy and Rhabdomyolysis.

作者信息

Ranabhat Kushal, Deliwala Smit, Hussain MurtazaShabbir, Haykal Tarek, Bachuwa Ghassan

机构信息

Internal Medicine, Michigan State University at Hurley Medical Center, Flint, USA.

Division of Oncology, Department of Internal Medicine, Duke University, Durham, USA.

出版信息

Cureus. 2021 Apr 19;13(4):e14559. doi: 10.7759/cureus.14559.

Abstract

Human immunodeficiency virus (HIV) characteristically presents as a mononucleosis-like prodrome; rhabdomyolysis as a sole manifestation remains a rare finding from infection to seroconversion. A young male with a vague sexual history presented with myopathy progressing rapidly to rhabdomyolysis and renal failure. Acute HIV rarely presents with classic features, and rhabdomyolysis seems to manifest more in younger patients. Our case also demonstrates the importance of keeping a strong suspicion for HIV in the right setting despite false-negative results in the pre-seroconversion phase. The variability in HIV presentation and stigma of sexual history taking represents a diagnostic challenge. The astute clinician must be privy to these peculiarities to formulate a prompt diagnosis.

摘要

人类免疫缺陷病毒(HIV)通常表现为类似单核细胞增多症的前驱症状;从感染到血清转化,横纹肌溶解作为唯一表现仍然是罕见的发现。一名有模糊性病史的年轻男性出现肌病,并迅速发展为横纹肌溶解和肾衰竭。急性HIV很少表现出典型特征,横纹肌溶解似乎在年轻患者中更易出现。我们的病例还表明,尽管在血清转化前期出现假阴性结果,但在合适的情况下对HIV保持高度怀疑很重要。HIV表现的变异性以及获取性病史时的污名化构成了诊断挑战。敏锐的临床医生必须了解这些特殊情况以便做出快速诊断。

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