A Case Report: False-Negative HIV Antibody Test in a Patient Presenting With an Unusual Case of Cytomegalovirus Oropharyngeal Ulcerations

被引:1
作者
Kandiwo, Nyakulira [1 ]
Hapunda, Racheal [1 ]
Chanda, Chitalu [2 ,3 ]
Shams, Madeeha [4 ]
Toeque, Mona-Gekanju [5 ,6 ]
Riedel, David J. [5 ,6 ]
Mumbi, Willard [1 ]
Mulenga, Lloyd [2 ,3 ,4 ]
Claassen, Cassidy W. [2 ,3 ,5 ,6 ]
Fwoloshi, Sombo [2 ,3 ]
Hachaambwa, Lottie [2 ,3 ,5 ,6 ]
机构
[1] Univ Zambia, Sch Med, Lusaka Eye Hosp, Dept Otolaryngol, Lusaka, Zambia
[2] Univ Zambia, Sch Med, Div Infect Dis, Dept Med, Lusaka, Zambia
[3] Univ Teaching Hosp, Adult Infect Dis Ctr, Lusaka, Zambia
[4] Minist Hlth, Ndeke House, Lusaka, Zambia
[5] Univ Maryland, Sch Med, Baltimore, MD 21201 USA
[6] Univ Maryland, Sch Med, Ctr Int Hlth Educ & Biosecttr, 725 West Lombard, Baltimore, MD 21201 USA
关键词
HIV-1; human immunodeficiency virus (type 1); AIDS; advanced immunodeficiency syndrome; HIV seronegative; PCR; polymerase chain reaction; cytomegalovirus; CMV; sub-Saharan Africa; Zambia; IMMUNODEFICIENCY-VIRUS TYPE-1; INFECTION; RESPONSES; INFANT; COHORT;
D O I
10.1097/IPC.0000000000001241
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Cytomegalovirus (CMV) oropharyngeal ulcerations are rare diagnoses that usually only occur in immunocompromised individuals. False-negative third-generation HIV tests in a patient with AIDS are also exceedingly rare and, when they occur, underscore the complex host and viral relationships involved in HIV disease mediation. Case Presentation: We present a case of CMV oropharyngeal ulcerations in a patient diagnosed with advanced AIDS with a persistently negative HIV antibody test. Confirmative testing and diagnosis of HIV were performed with a qualitative DNA polymerase chain reaction and confirmed with a quantitative RNA polymerase chain reaction. Cytomegalovirus oropharyngeal ulcerations were managed with ganciclovir 5 mg/kg with significant improvement in oral ulcers. Conclusions: We present a rare case of an HIV-seronegative patient clinically diagnosed with advanced AIDS and CMVoropharyngeal ulcerations. False-negative HIV tests can delay diagnosis and treatment; hence, clinical suspicion is needed for accurate diagnosis and early treatment.
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