获得性免疫缺陷综合征合并神经梅毒及巨细胞病毒脑炎一例并相关文献分析  

A case of acquired immune deficiency syndrome combined with neurosyphilis and cytomegalovirus encephalitis and related literature review

作　　者：周莹莹 邓莉平[2] 鲁植艳[3] 苏志颖 熊勇[2] Zhou Yingying;Deng Liping;Lu Zhiyan;Su Zhiyin;Xiong Yong(Department of Infectious Diseases,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Imaging,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]温州医科大学附属衢州医院呼吸与危重医学科,衢州市324000 [2]武汉大学中南医院感染科,武汉市430071 [3]武汉大学中南医院影像科,武汉市430071

出　　处：《中华实验和临床感染病杂志（电子版）》2021年第5期350-355,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：“十三五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(No.2017ZX10202101-001)。

摘　　要：目的提升对获得性免疫缺陷综合征(AIDS)合并神经梅毒及巨细胞病毒脑炎的认识。方法分析1例AIDS合并神经梅毒及巨细胞病毒脑炎患者的诊疗经过,并结合相关文献进行复习。结果 1例CD4+T细胞为65个/μl的21岁AIDS男性患者,因发热和构音障碍于2019年6月14日至武汉大学中南医院住院诊治,完善相关检查后确诊为梅毒螺旋体及巨细胞病毒混合颅内感染,脑部磁共振成像(MRI)提示颅内多发异常信号。经驱梅、抗巨细胞病毒并及时启动高效抗反转录病毒治疗(HAART)等综合治疗后症状明显缓解,颅内多发异常信号较前吸收,预后较好。结论 AIDS合并神经梅毒和巨细胞病毒脑炎应及时诊断,给予驱梅、抗巨细胞病毒等综合治疗并适时启动HAART,可改善患者预后。Objective To enhance the awareness on acquired immune deficiency syndrome(AIDS) combined with neurosyphilis and cytomegalovirus encephalitis. Method The process of diagnosis and treatment of one AIDS patient combined with neurosyphilis and cytomegalovirus encephalitis were analyzed,and the related literature were reviewed. Results On June 14 th, 2019, a 21-year-old male AIDS patient with CD4+ T as 65 cells/μl was admitted to Zhongnan Hospital of Wuhan University due to fever and dysarthria.The case was diagnosed as mixed infection of treponema pallidum and cytomegalovirus after complete examination. The magnetic resonance imaging(MRI) of brain showed multiple abnormal intracranial signals.The condition of the patient was relieved and multiple abnormal intracranial signals were absorbed and the prognosis was relatively well after anti-treponema pallidum, anti-cytomegalovirus and initiation of highly active antiretroviral therapy(HAART) at the right moment. Conclusions For patients with AIDS combined with neurosyphilis and cytomegalovirus encephalitis, timely diagnosis, combined treatment with antitreponema pallidum and anti-cytomegalovirus and initiation of HAART at the right moment could improve the prognosis.

关 键 词：获得性免疫缺陷综合征 神经梅毒 巨细胞病毒脑炎 

分 类 号：R512.91[医药卫生—内科学] R759.1[医药卫生—临床医学] R742.9