Chinese Medical Sciences Journal ›› 2019, Vol. 34 ›› Issue (1): 55-59.doi: 10.24920/003460

• 病例报道 • 上一篇    下一篇

人类免疫缺陷病毒-1感染急性期双侧面神经麻痹合并脑膜炎1例

吴焱1,2,宋歌2,魏春波1,伦文辉1,2,*()   

  1. 1 首都医科大学附属北京地坛医院感染病诊治研究中心,北京 100015
    2 北京大学地坛医院教学医院皮肤性病科,北京 100015
  • 收稿日期:2018-02-02 修回日期:2019-02-22 出版日期:2019-03-30 发布日期:2019-04-08
  • 通讯作者: 伦文辉 E-mail:lunwenhui@163.com

Bilateral Peripheral Facial Paralysis Combined with HIV Meningitis During Acute HIV-1 Infection: A Case Report

Wu Yan1,2,Song Ge2,Wei Chunbo1,Lun Wenhui1,2,*()   

  1. 1 Department of Dermatology and Venereology, Beijing Ditan Hospital Affiliated to Capital Medical University, Beijing 100015, China
    2 Infectious Disease Center, Peking University Ditan Teaching Hospital, Beijing 100015, China
  • Received:2018-02-02 Revised:2019-02-22 Published:2019-03-30 Online:2019-04-08
  • Contact: Lun Wenhui E-mail:lunwenhui@163.com

摘要:

本研究报道了1例人类免疫缺陷病毒(HIV)感染出现双侧周围性面神经麻痹的病例。一名38岁的男性同性恋患者因双侧面瘫来我院就诊,入院前21天,患者出现高热(达39℃)、畏寒、头痛、疲劳、全身不适、恶心、呕吐等症状。神经系统检查显示:双侧周围性面神经麻痹,双唇和双侧脸颊下垂,双眼睑闭合不全。脑脊液检查结果显示:细胞数增多,微量总蛋白含量显著升高,脑脊液中鞘内IgG合成明显增多。ELISA初筛检测显示HIV-1血清学呈阳性,Western blot进一步确认了阳性结果。CD4+细胞计数为180/mm3。脑脊液病毒载量为血浆病毒载量的10倍。患者的健康状况不断改善,双侧面神经麻痹于2个月后完全缓解。

关键词: 人类免疫缺陷病毒, 获得性免疫缺陷综合征, 急性人类免疫缺陷病毒1感染, 周围性面神经麻痹, 双侧面神经麻痹

Abstract:

Here we reported a Chinese case of bilateral peripheral facial paralysis (PFP) in human immunodeficiency virusc (HIV) infected population. A 38-year-old homosexual male patient was referred to our hospital for bilateral facial paralysis. 21 days prior to admission he had developed high fever, chills, headache, fatigue, general malaise, nausea and vomiting. Neurological examination revealed bilateral ptosis of lower lip and cheeks, as well as failure of bilateral eyes closure. Analysis of cerebrospinal fluid (CSF) revealed pleocytosis, a marked rise of micro total protein and a marked rise of intrathecal lgG synthesis. The result of HIV-1 serology was positive by ELISA and that was confirmed by western blot. His CD4 + cell count was 180 cells/mm 3. HIV-1 viral load in CSF was almost 10 times higher than that in plasma. The patient’s condition improved steadily and experienced complete resolution of bilateral PFP after 2 months.

Key words: human immunodeficiency virus, acquired immune deficiency syndrome, acute human immunodeficiency virus-1 infection, peripheral facial paralysis

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