ABSTRACT
Although primary human immune deficiency virus (HIV) infection is a well described entity, it is frequently misdiagnosed or underdiagnosed. This has been attributed to the non-specific clinical features at presentation, inadequate history taking and a low index of suspicion by practicing clinicians. Haematological abnormalities are a recognised feature of HIV infection and may present in the form of pancytopenia or isolated cytopenias. One of the cardinal features of HIV seroconversion is leucopenia, however primary HIV infection as a cause of neutropenia and lymphopaenia in Crohn’s disease, has to our knowledge, not been described in the medical literature. We present a case of profound neutropenia in Crohn’s disease secondary to acute HIV sero-conversion illness.
ABSTRACT
La primoinfección por el virus de la inmunodeficiencia humana (VIH) es sintomática en casi el 70% de los casos pero en la mayoría de ellos, el diagnóstico pasa desapercibido debido a su sintomatología inespecífica, el conjunto de manifestaciones clínicas se conoce como síndrome retroviral agudo. Al ser sub diagnosticada la enfermedad es potencialmente contagiosa en su período latente o diagnosticada en la etapa SIDA. El caso clínico es un masculino de 31 años de edad, ingresa al Hospital Clínico Viedma el 19 de marzo del 2014, con alzas térmicas no cuantificadas, lesiones máculopapulosas diseminadas con predominio en tórax y miembros superiores no dolorosas, pruriginosas además de rinorrea, astenia, anorexia y odinofagia progresiva. El paciente tenía antecedente de enfermedad de dengue hace un mes. Se realiza serología, con ELISA positivo para VIH y Western Blot indeterminado. Se solicita carga viral con valores extremadamente altos confirmando la primoinfección por VIH.
Primary infection by the virus of the human immunodeficiency virus (HIV) is symptomatic in about 70% of cases but in most of them, the diagnosis goes unnoticed because of its nonspecific symptoms, the set of clinical manifestations is known as acute retroviral síndrome. When the disease is diagnosed sub potentially contagious in the latent period or AIDS diagnosed in stage. The clinical case is a male of 31 years old, entered the Hospital Viedma on march 19, 2014, with unquantified thermal spikes, maculopapular lesions scattered predominantly in the chest, not painful, itchy runny nose plus upper limbs, with asthenia, anorexia and progressive odynophagia. The patient had a history of dengue illness a month ago. Serology was performed with positive HIV ELISA and Western Blot indeterminate. Viral load is requested with extremely high values confirming HIV primary infection.
Subject(s)
HIV TestingABSTRACT
ABSTRACT: A case of infectious mononucleosis (IM) in a previously healthy 43-year-old male is presented. The patient complained of fever and a sore throat of 3 weeks' duration. Although blood tests showed a marked increase in atypical lymphocytes, tests for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were negative. Human immunodeficiency virus type 1 (HIV-1) antibody was positive on enzymelinked immunosorbent assay (ELISA), and the HIV-1 viral load was 6.4×10<SUP>4</SUP>copies/mL. Western blot (WB) analysis did not initially confirm HIV-1 infection ; however, HIV-1 infection was confirmed one month after presentation. Although several pathogens can cause infections presenting as IM, in Japan there have been few reports of acute retroviral syndrome presenting as IM. This case is being reported to stress the importance of the early diagnosis of acute retroviral syndrome.