매독성 유두염으로 나타난 후천성 면역 결핍증 환자 1예
A case of the human immunodeficiency virus type 1-infected patient presented as a syphilitic papillitis
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초록
HIV 감염이 증가하면서 여러 감염병의 유병율과 임상양상에 많은 변화가 일어나고 있다. 오래 전부터 인류에게 알려진 성 전파성 질환인 매독은 HIV 시대에 더욱 다양한 임상양상으로 나타나고 있다. 저자들은 HIV-1 감염과 함께 매독성 유두염으로 발현한 제2기 매독으로 진단된 1예를 치료 경험을 문헌고찰과 함께 보고하는 바이다. 42세 남자 환자가 원인불명의 재발성 포도막염으로 안과의원에서 반복적인 치료를 받아왔으나 뚜렷한 호전이 없었으며, 이후 시행한 HIV-1 항체와 VDRL 검사에서 모두 양성을 보여 HIV 감염 및 매독성 유두염으로 진단받았다. 환자는 penicillin G 240만 단위를 7일마다 6차례에 걸쳐 근육주사로 치료받았으며 2개월 후 안구증상이 재발하였으며, 다시 한번 penicillin G 240만 단위로 6차례 근육 주사하여 치료하였고, 이후 20개월이 경과한 현재까지 재발 없이 추적관찰 중이다.
Abstract
The number of HIV infection is increasing nowadays, and some infectious diseases complicated in HIV- infected hosts reveal different clinical features from those well known from the past. Syphilis seems to show more rapid disease progression and many clinical features in HIV-infected hosts. We experienced a HIV-infected patient who had presented as syphilitic papillitis. A 42-year old man complaining of decreased visual acuity and eye ball redness was referred to our medical center. He had a history of recurrent uveitis for past 3 months, which was refractory to the conventional therapy. The patient was confirmed as having HIV-1 infection and syphilitic papillitis. He was treated with penicillin G 2.4 million units intramuscularly weekly for 6 weeks and anti-retroviral agents. However, ocular symptoms for syphilis recurred two months later, and the patient was retreated with the same regimen and cured.
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