Lee Yi-Chieh, Li Hsueh-Yu, Lin Wan-Ni
Department of Otolaryngology Head & Neck Surgery, Chang Gung Memorial Hospital at Linkou, 5 Fushing St., Taoyuan 333, Taiwan.
London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Microorganisms. 2022 Dec 5;10(12):2404. doi: 10.3390/microorganisms10122404.
Diagnosis of the Human Immunodeficiency Virus (HIV) remains challenging due to non-specific clinical presentations and mostly flu-like symptoms, e.g., fever, headache, sore throat, and general weakness. Oral lesions, such as oral candidiasis and Kaposi sarcoma, are also frequently associated with HIV infection, whereas laryngeal manifestations are rare. We report two cases of newly diagnosed HIV patients with clinical presentations of sore throat, and endoscopy revealed an epiglottic ulcerative tumor-like lesion. A laryngomicrosurgical biopsy of the lesions was performed for persistent symptoms and suspicion of malignancy. The result revealed acute and chronic inflammation without a conclusive pathology diagnosis. Further laboratory analysis was arranged in consideration of autoimmune diseases, Epstein-Barr virus (EBV), and HIV infection due to their persistent and atypical symptoms. The results were positive for HIV infection. These patients were treated successfully with antiviral treatment and the laryngeal symptoms improved within weeks. In patients with idiopathic and persistent epiglottitis or an epiglottic ulcer after medical treatment, HIV infection needs to be considered as a potential etiology in order to institute proper treatment.
由于临床表现不具特异性且大多为类似流感的症状，如发热、头痛、咽痛和全身乏力，人类免疫缺陷病毒（HIV）的诊断仍然具有挑战性。口腔病变，如口腔念珠菌病和卡波西肉瘤，也常与HIV感染相关，而喉部表现则较为罕见。我们报告了两例新诊断的HIV患者，临床表现为咽痛，内镜检查发现会厌有溃疡性肿瘤样病变。针对持续症状和怀疑为恶性肿瘤的情况，对病变进行了喉显微手术活检。结果显示为急性和慢性炎症，无明确的病理诊断。鉴于其持续且不典型的症状，考虑到自身免疫性疾病、爱泼斯坦-巴尔病毒（EBV）和HIV感染，安排了进一步的实验室分析。结果显示HIV感染呈阳性。这些患者通过抗病毒治疗成功治愈，喉部症状在数周内得到改善。对于经药物治疗后患有特发性持续性会厌炎或会厌溃疡的患者，需要考虑HIV感染作为潜在病因，以便进行适当的治疗。
