Cervical Tuberculous Lymphadenitis as the Main Symptom Before HIV Seropositive Status is Confirmed-Report of Four Cases

頸部結核菌淋巴腺炎為首要病徵進而診斷為愛滋病患者－四例報告

邱贊仁(Tsan-Jen Chiu) ； 沈宗憲(Tzung-Shiahn Sheen) ； 吳振都(Chen-Tu Wu) ； 洪健清(Chien-Ching Hung)

《慈濟醫學雜誌》 14卷2期 (2002/04) Pp. 113-119

https://doi.org/10.6440/TZUCMJ.200204.0113

摘要

結核病是愛滋病病人重要而且常見的伺機性感染之一，它可以出現於愛滋病的各個時期。相較於美國和非洲，臺灣的愛滋病對於結核病盛行率的衝擊並未被強調，然而，我們仍然經驗四名以頸部結核菌淋巴腺炎為首要病徵，進而診斷為愛滋病患者。換言之，潛藏於結核病人中的愛滋病的危險因子或免疫功能下降的病徵時，愛滋病相關的淋巴病變必須列為鑑別診斷之一。對於結核菌淋巴腺炎的病患，尤其是具有感染愛滋病危險因子的患者，建議應實施愛滋病毒抗體篩檢，以利早期發現及治療具有結核菌及愛滋病毒雙重感染的病患。

關鍵字

人類免疫缺乏病毒 ； 後天免疫缺乏症候群 ； 結核病 ； 淋巴結切片

並列摘要

Tuberculosis (TB), an important and common opportunistic infection in patients with HIV infection/AIDS, can occur at any stage of HIV infection. Unlike the United States and Africa, the impact of HIV infection on the prevalence of tuberculosis has not been emphasized in Taiwan. Nevertheless, we encountered four patients in whom cervical tuberculous lymphadenitis was their main early symptom, and HIV infection was later diagnosed. It is important in clinical medicine and public health to know that many HIV carriers are among the crowds of patients with tuberculosis. In other words, when a patient presents with a neck mass in conjunction with any HIV-infection risk factors or immunodeficiency symptoms, HIV-related lymphadenopathy must be included in the differ-ential diagnoses. We propose that serologic tests for HIV infection be performed in patients with tuberculous lymphadenitis espe-cially in those with known risk factors of HIV. In this way, patients who have been coinfected with tuberculosis and HIV can be discovered and treated at an early stage.

並列關鍵字

human immunodeficiency virus (HIV) ； acquired immunodeficiency syndrome (AIDS) ； tuberculosis (TB) ； lymph node biopsy