1988 Volume 29 Issue 5 Pages 711-717
Acquired immunodeficiency syndrome (AIDS) in a 37-year-old Japanese man is reported. The patient was admitted on February 17, 1986, because of generalized weakness, fever, cough and dyspnea which were lasted for 10 days. He had been in San Francisco for 15 years untill May, 1984. He was not a drug abuser but a homosexual with frequent sexual contacts in San Francisco.
General examination revealed obvious recent weight loss and moderate bilateral lymphadenopathy on the cervical, axillary and inguinal regions. A chest X-ray film showed diffuse infiltration on both lung fields without pleural effusion. Blood chemistry and electrolyte levels were normal expect the elevated level of LDH, hyponatremia and hyperkalemia in the terminal stage. The leukocyte count was 9,500/μl with 78% granulocytes (9% band forms), 4% monocytes and 18% lymphocytes. The ratio of CD4 to CD8 cells was 0.06. The levels of IgA and IgE were increased. He had no response to skin test with purified protein derivative. Mitogenic responses to PHA, ConA and PWM were reduced. Antibody to HIV (HTLV-III (ELISA), LAV (IF)) was detected in the serum, which was confirmed by Western blot analysis.
From these findings, he was diagnosed as having AIDS. The patient was treated with antibiotics including sulfamethxazole-trimethoprim and flucytosin. However, his condition continued to deteriorate and died of pneumonia on March 7. Autopsy revealed pneumocystis carinii pneumonia, cytomegalovirus adrenalitis with necrotizing adrenalitis and lymphoid atrophy. There was no evidence of Kaposi's sarcoma.
