Cordoliani F, Vignon-Pennamen M D, Assous M V, Vabres P, Dronne P, Rybojad M, Morel P
Service de Dermatologie, Hôpital Saint-Louis, Paris, France.
Br J Dermatol. 1997 Sep;137(3):437-9.
We report the fourth case of Lyme borreliosis in a man infected with human immunodeficiency virus (HIV). The erythema chronicum migrans was persistent, overlapping with meningoradiculitis. Repeated immunofluorescence tests for Borrelia burgdorferi sensu lato remained negative in both sera and cerebrospinal fluid (CSF), the enzyme-linked immunosorbent assay was weakly positive in serum and CSF and a Western blot was positive. The skin infiltrate was composed mostly of T lymphocytes with a CD4/CD8 ratio of 0.5. The course of the disease was favourable after treatment with intravenous ceftriaxone. Further studies are necessary to evaluate whether HIV infection influences, as does syphilis, the course and response to treatment of Lyme borreliosis. Serological tests are insufficiently sensitive and the Western blot assay is necessary to confirm Lyme disease in HIV-positive patients.
我们报告了第四例感染人类免疫缺陷病毒（HIV）的男性莱姆病病例。慢性游走性红斑持续存在，并伴有脑脊神经根炎。对伯氏疏螺旋体广义种进行的反复免疫荧光试验在血清和脑脊液（CSF）中均呈阴性，酶联免疫吸附试验在血清和脑脊液中呈弱阳性，免疫印迹呈阳性。皮肤浸润主要由T淋巴细胞组成，CD4/CD8比值为0.5。静脉注射头孢曲松治疗后疾病进程良好。有必要进行进一步研究，以评估HIV感染是否如梅毒一样影响莱姆病的病程和对治疗的反应。血清学检测灵敏度不足，免疫印迹试验对于确诊HIV阳性患者的莱姆病很有必要。
