感染症学雑誌
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
症例
水痘・帯状疱疹ウイルスによる免疫再構築症候群で多発脳神経麻痺を来したHIV 感染者の1 例
関谷 綾子城川 泰司郎宮下 竜伊一木 昭人近澤 悠志備後 真登村松 崇横田 和久四本 美保子萩原 剛天野 景裕福武 勝幸
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ジャーナル フリー

2019 年 93 巻 6 号 p. 775-779

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Varicella zoster virus (VZV) is known to cause immune reconstitution inflammatory syndrome (IRIS) in a high frequency in people infected with human immunodeficiency virus (HIV). However, severe cases of IRIS resulting in multiple cerebral nerve palsy are rare. We herein report on a case of an HIV-infected man who developed IRIS caused by VZV, presenting as multiple cranial nerve palsy involving cranial nerves V,VII, VIII, IX, X, and XII. The patient was a 40-year-old man who was diagnosed as having AIDS triggered by esophageal candidiasis 3 months previously. About 3 months after starting antiretroviral drug treatment,he was hospitalized with difficulty in swallowing, fever, and an exacerbated rash. His CD4 cell count was 42 cells/μL, and the HIV-RNA level was undetectable. The characteristic symptom of papules and scabs of different stages all over the body enabled us to quickly reach the correct diagnosis of VZV-IRIS. The patient was treated with acyclovir, corticosteroid pulses, and antiretroviral therapy. Although the patientʼs hypoglossal nerve palsy quickly improved, his swallowing difficulty required over 8 months to improve.

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© 2019 一般社団法人 日本感染症学会
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