지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2011.1
- 수록면
- 262 - 265 (4page)
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초록· 키워드
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The optimal and alternative antimicrobial regimens to treat neurosyphilis in human immunodeficiency virus (HIV) infected patients remain controversial. Little is known concerning the efficacy of ceftriaxone. A 75-year-old heterosexual man visited an outpatient clinic due to incidentally detected positive serum Venereal disease research laboratory (VDRL) and Fluorescent treponemal antibody absorbed tests in routine preoperative checkup. Because of benzathine penicillin was unavailable to use, 4-week regimen with doxycycline was started. After 2 weeks doxycycline treatment, a severe headache suddenly occurred. Cerebrospinal fluid (CSF) analysis showed mild lymphocyte-dominant pleocytosis, increased protein, and weakly reactive VDRL test. ELISA for HIV antibody and Western blot assay revealed he is infected with HIV. Initial CD4+ T cell count was 220/mm^3 and the load of HIV RNA was 5,200 copies/mL. The most probable diagnosis was deemed to be neurosyphilis, considering the possibilities of Jarisch-Herxheimer reaction or doxycycline-induced pseudotumor cerebri. In the absence of procaine penicillin G in our hospital, intravenous ceftriaxone was administered and highly active antiretroviral therapy was started. After 14days of treatment, the patient no longer had a headache and the CSF profile was improved. Additional follow-up CSF analysis was done 3months after treatment. CSF pleocytosis and protein level were decreased and the CSF VDRL was converted to negative. Ceftriaxone may be a good alternative in the treatment of neurosyphilis in HIV infected patient.
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참고문헌 (19)
참고문헌 신청
Bordon J / 1995 / Neurosyphilis in HIV-infected patients / Eur J Clin Microbiol Infect Dis 14 : 864 ~ 869
Cnossen WM / 1995 / Ceftriaxone treatment of penicillin resistant neurosyphilis in alcoholic patients / J Neurol Neurosurg Psychiatry 59 : 194 ~ 195
De Maria A / 1997 / Minocycline for symptomatic neurosyphilis in patients allergic to penicillin / N Engl J Med 337 : 1322 ~ 1323
Doherty L / 2002 / Syphilis: old problem, new strategy / BMJ 325 : 153 ~ 156
Dowell ME / 1992 / Response of latent syphilis or neurosyphilis to ceftriaxone therapy in persons infected with human immunodeficiency virus / Am J Med 93 : 481 ~ 488
Cnossen WM / 1995 / Ceftriaxone treatment of penicillin resistant neurosyphilis in alcoholic patients / J Neurol Neurosurg Psychiatry 59 : 194 ~ 195
De Maria A / 1997 / Minocycline for symptomatic neurosyphilis in patients allergic to penicillin / N Engl J Med 337 : 1322 ~ 1323
Doherty L / 2002 / Syphilis: old problem, new strategy / BMJ 325 : 153 ~ 156
Dowell ME / 1992 / Response of latent syphilis or neurosyphilis to ceftriaxone therapy in persons infected with human immunodeficiency virus / Am J Med 93 : 481 ~ 488
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