血液培养-阴性心血管梅毒在未经治疗的艾滋病毒阳性男性
Habib Behjatnia1, Antonio Crespo2, Yiliam Castillo2
1Department of Internal Medicine, Orlando Regional Healthcare System, Orlando, FL, USA.
The American journal of case reports
|January 8, 2026
概括
心血管梅毒是一种罕见的血液培养负性内心炎的原因,可能危及生命. 这一案例凸显了艾滋病毒和缺乏治疗可能如何加速梅毒的进展,使内心炎的管理复杂化.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 泌尿生殖系统医学
背景情况:
- 血培养阴性内心炎 (BCNE) 是一种严重的心脏感染.
- 由Treponema pallidum引起的心血管梅毒是一种罕见的BCNE,影响主动脉,偶尔会影响主动脉.
- 与人类免疫缺陷病毒 (HIV) 的同时感染很常见,缺乏抗逆转录病毒疗法可能会加剧梅毒的进展.
研究的目的:
- 在未经治疗的HIV患者中报告罕见的梅毒内心炎病例.
- 强调这种疾病的诊断挑战和治疗影响.
- 为了突出膜梅毒的不寻常表现,而没有显著的大动脉参与.
主要方法:
- 一个44岁的男性心力衰竭和未经治疗的HIV病例报告.
- 诊断工作包括输食管回声心电图,快速血试剂 (RPR) 测试和血液培养.
- 致病原体 (T. pallidum) 通过16S rRNA测序在已开拓的大动脉组织上进行鉴定.
主要成果:
- 患者呈现出大动脉损伤,阴性血液培养和高RPR标位 (1:128).
- 梅毒内心炎的诊断通过对大动脉的遗传测序证实.
- 通过大动脉置换和抗生素 (青素和 ceftriaxone) 成功治疗.
结论:
- 梅毒内心炎是一种罕见但危及生命的诊断.
- 艾滋病毒阳性和不坚持抗逆转录病毒疗法可能加速疾病进展和治疗复杂性.
- 在这种膜梅毒病例中,典型的大动脉干扰的缺乏是非常不寻常的.
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