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후천성 면역 결핍증 환자에서 뇌졸중으로 발생한 신경매독 1예

A Case of Neurosyphilis Presenting as a Stroke in a Patient with Human Immunodeficiency Virus Infection

  • 서재현 (가톨릭대학교 의과대학 내과학교실) ;
  • 이상록 (청주성모병원 내과) ;
  • 김세영 (가톨릭대학교 의과대학 내과학교실) ;
  • 이준섭 (가톨릭대학교 의과대학 내과학교실) ;
  • 이경은 (가톨릭대학교 의과대학 내과학교실) ;
  • 이해림 (가톨릭대학교 의과대학 내과학교실) ;
  • 이연수 (청주성모병원 신경과)
  • Seo, Jae Hyun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Sang-Rok (Department of Internal Medicine, Cheongju St. Mary's Hospital) ;
  • Kim, Se Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Joune Seup (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Kyoung-Eun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Hae Lim (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Yeon Su (Department of Neurology, Cheongju St. Mary's Hospital)
  • 투고 : 2012.05.03
  • 심사 : 2012.11.27
  • 발행 : 2013.06.01

초록

후천성 면역 결핍증 환자에서 신경매독이 발생할 확률은 정상인에 비해 높으며, 임상 증상은 다양하게 나타날 수 있다. 후천성 면역 결핍증을 가진 42세 남자가 급성 뇌경색 형태의 신경 매독 증상을 보였으며 이에 대해 항 혈소판 치료, 항생제 치료, 항 바이러스 치료를 함께 시행하였고, 성공적으로 치료하였기에 증례로 보고하는 바이다.

While the neurologic manifestations of syphilis are diverse, stroke is a rare initial manifestation. We report a human immunodeficiency virus (HIV)-positive patient whose neurosyphilis presented as a stroke. A 42-year-old male visited the emergency room due to decreased mental functioning. Brain magnetic resonance imaging showed acute infarct on the left frontal, temporal, and parietal lobes. A serum Venereal Disease Research Laboratory (VDRL) test was positive. ELISA for HIV antibody and Western blot assays revealed he was infected with HIV. The cerebrospinal fluid (CSF) VDRL test was positive and protein was increased. The patient was treated with heparization and penicillin G for 14 days. His mental status improved with treatment, and CSF protein and VDRL titers were also decreased 3 months after treatment.

키워드

참고문헌

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