黑热病合并HIV感染3例误诊分析

Analysis of Misdiagnosis about three cases with Leishmaniasis and HIV Co-infection

目的探讨黑热病合并HIV感染误诊的原因及防范策略。方法回顾性分析3例黑热病合并HIV感染患者的临床资料。结果该3例主要表现为长期反复出现不规则发热、全血细胞减少、肝脾淋巴结肿大和皮肤损害等症状,骨髓或淋巴结穿刺物涂片中均检出利什曼原虫无鞭毛体,血清免疫学检查为强阳性。结论黑热病合并HIV感染的临床表现虽无特异性,但实验室检查灵敏度和特异性较高,提高非疫源性地区医务人员的诊断意识和能力、及时完善实验室的各项检查,可避免或减少其误诊。

Objective To analyze the causes and discuss the preventive measures of misdiagnosis of three cases with Leishmaniasis and HIV Co-infection. Methods Retrospectively analyze the correlative clinical information and laboratory datas of the three cases. Results The long-term irregular fever,pancytopenia, hepatosplenomegaly and skin lesion are the common typical clinical symptoms. Leishmanias which have no atrichosis were found in the bone marrow and pathological lymph nodes of the three patients, and the seroimmunity tests were all strong- ly positive. Conclusion Although the clinical symptoms of leishmaniasis and HIV Co-infection are not specif- ic, the sensitivity and specificity of laboratory tests were high. To improve the Medical Staff＇s diagnosis ability and perfect the correlative laboratory tset is the key to reduce the misdiagnosis.