三例传染性单核细胞增多症同时伴有非特异性和特异性试验假阳性:伪装成梅毒的血清学发现。

IF 1.9 4区 医学 Q3 INFECTIOUS DISEASES Journal of Infection and Chemotherapy Pub Date : 2024-10-17 DOI:10.1016/j.jiac.2024.10.011
Naoki Matsuura
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引用次数: 0

摘要

在各种情况下,包括在传染性单核细胞增多症患者中,都会出现非三阳梅毒检测的生物假阳性反应。然而,梅毒检测结果呈假阳性的报道却很少见。我们介绍了三例与爱泼斯坦-巴氏病毒相关的传染性单核细胞增多症病例,这些病例的梅毒螺旋体检测和非螺旋体检测结果同时呈假阳性,有效地模仿了梅毒血清学检测。值得注意的是,梅毒螺旋体检测的假阳性结果是一过性的,持续了 6 个多月才转为阴性。这种情况在真正的苍白螺旋体感染(梅毒)中并不典型,在梅毒感染中,三螺旋体检测结果通常终身呈阳性。这组病例突出了误诊的可能性,并强调了在传染性单核细胞增多症的背景下仔细解读梅毒血清学结果的重要性。当梅毒患者没有典型梅毒症状时,这一点尤为重要。传染性单核细胞增多症和梅毒的临床表现相似,包括咽痛、淋巴结病、皮疹和肝炎,这使得诊断过程更加复杂。临床医生在解读梅毒血清学阳性结果时,应考虑近期出现的与爱泼斯坦-巴氏病毒相关的传染性单核细胞增多症,尤其是出现类似单核细胞增多症症状的年轻成人。后续血清学检测有助于避免不必要的治疗和潜在的患者管理不当。
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Three cases of infectious mononucleosis with concurrent false-positive non-treponemal and treponemal tests: Serological findings masquerading as syphilis.

Biological false-positive reactions to non-treponemal syphilis tests occur under various conditions, including in patients with infectious mononucleosis. However, false-positive treponemal test results are rarely reported. We present three cases of Epstein-Barr virus-associated infectious mononucleosis that exhibited concurrent false-positive results in both treponemal and non-treponemal tests, effectively imitating syphilis serology. Notably, the false-positive treponemal test results were transient and persisted for more than 6 months before reverting to negative. This is atypical for true Treponema pallidum infection (syphilis), in which treponemal tests usually remain positive for life. This case series highlights the potential for misdiagnosis and emphasizes the importance of careful interpretation of syphilis serology results in the context of infectious mononucleosis. This is particularly important when typical syphilis symptoms are absent, as in our patients. The similarity in the clinical manifestations between infectious mononucleosis and syphilis, including sore throat, lymphadenopathy, rash, and hepatitis, further complicates the diagnostic process. Clinicians should consider recent Epstein-Barr virus-associated infectious mononucleosis when interpreting positive syphilis serology, especially in young adults presenting with mononucleosis-like symptoms. Follow-up serological testing is useful to avoid unnecessary treatment and potential patient mismanagement.

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来源期刊
Journal of Infection and Chemotherapy
Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
4.10
自引率
4.50%
发文量
303
审稿时长
47 days
期刊介绍: The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.
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