難治性咽頭潰瘍で初発したＨＩＶ感染症

Abstract

Human immunodeficiency virus (HIV) infection induces acquired immunodeficiency syndrome (AIDS) as a consequence of collapsed immunity ten or more years after infection. At present, the number of HIV-infected patients is supposed to be about 39, 400, 000 worldwide. In Japan, the total number of HIV and AIDS patients may be over 10, 000 and the most frequent cause is homosexual intercourse. We report on a patient with intractable pharyngeal ulceration who consulted our clinic for pharyngeal and swallowing pain and was finally diagnosed as HIV-positive.Case A: 36-year-old man. His complaint started at the beginning of June 2006. He was treated for pharyngitis at a local clinic of internal medicine, but there was no response. Therefore, he was referred to our clinic on July 24th. An oro-pharyngeal examination demonstrated an ulcer and white furred region at the right oropharynx and left aryepiglottic fold. A cuture of hemanalysis demonstrated panhematopenia and the white furred region showed indigenous bacterial flora. Swallowing pain increased and he was admitted to our hospital on August 24th. Since he was noncompliant with antiseptic medication at the outpatient clinic, we suspected the possibility of a sexually transmitted infection at admission. It was determined that he was homosexual and HIV-positive. As a result of conservative therapy pharyngeal pain has diminished and the treatment of AIDS was started after referred to the general clinical department. We report the characteristics of HIV-positive induced oro-pharyngeal symptoms with a review of the literature.