White W B, Hanna M, Stewart J A
Arch Intern Med. 1984 Apr;144(4):826-7. doi: 10.1001/archinte.144.4.826.
A 24-year-old heterosexual man had severe proctalgia associated with nonspecific proctitis. Within a few days, perineal and lower extremity paresthesias, intermittent urinary retention, inguinal lymphadenopathy, lower extremity arthralgias, and aseptic meningitis developed. Serologic studies demonstrated a fourfold rise in convalescent antibody titer to herpes simplex virus (HSV) consistent with an initial type 2 infection. Six months later, HSV type 2 was isolated from perianal vesicles, which we believe was the first cutaneous manifestation of a recurrence. This unusual syndrome, presumably the result of HSV ganglionitis, could be confused with other disorders that include multiple sclerosis, lumbar disk disease with radiculopathy, rheumatologic disease, and psychogenic illness. In the absence of typical herpetic mucocutaneous vesicles, serologic studies may be useful in the diagnosis of a systemic herpes simplex infection.
一名24岁的异性恋男性患有与非特异性直肠炎相关的严重直肠疼痛。在几天内，出现了会阴和下肢感觉异常、间歇性尿潴留、腹股沟淋巴结病、下肢关节痛和无菌性脑膜炎。血清学研究显示，单纯疱疹病毒（HSV）恢复期抗体滴度升高四倍，符合初次2型感染。六个月后，从肛周水疱中分离出2型HSV，我们认为这是复发的首个皮肤表现。这种不寻常的综合征，推测是HSV神经节炎的结果，可能会与包括多发性硬化症、伴有神经根病的腰椎间盘疾病、风湿性疾病和精神性疾病在内的其他疾病相混淆。在没有典型疱疹性黏膜皮肤水疱的情况下，血清学研究可能有助于诊断全身性单纯疱疹感染。
