再発性難治性口内炎を主症状とした後天性免疫不全症候群（ＡＩＤＳ）例

Abstract

In Japan the numbers of patients with HIV (Human Immunodeficiency Virus) infection and AIDS (Acquired Immunodeficiency Syndrome) has increased gradually, while in other developed countries it has decreased remarkably. At present, the combined number of HIV and AIDS patients in Japan is supposed to be about 12,000. In Japan, most patients are concentrated in the major cities, therefore medical employees working in rural areas would be less likely to recognized this disease. However, at the present time, patients have become more scattered from urban areas to rural areas. Generally, most symptoms of AIDS start in the oro-pharyngeal region. Particularly candida infection frequently appears as a disturbance of immune response. Therefore, oto-rhino-laryngologists working in rural areas may encounter such patients. Our hospital is located in an agricultural district. We report a patient with recurrent intractable stomatitis who visited our clinic for oral-pharyngeal pain, and was finally diagnosed as having AIDS. A Case; A 42-year-old man consulted our clinic in May 2004. An oro-pharyngeal examination demonstrated white furred regions with or without ulcer dotted over the oral mucosa. Culture of a white furred region demonstrated candida albicans. The symptoms responded immediately to anti-fungal medicine. However, the symptoms recurred soon after stopping the medicine. Laboratory examination showed high levels of IgG and low levels of CH50. Based on persistent recurrence and examination data, we suspected that he might have immune functional disorders. Further laboratory examination demonstrated that he has been infected with HIV. Early detection could allow the patient to receive treatments earlier and save his life, as well as preventing him from infecting other people. Our report indicated that oto-rhino-laryngologists, particularly those working in rural areas should be reminded of the sings of HIV infection.