CONCOMITANT HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AND SYPHILITIC MENINGITIS

Syphilis has once again become a public health issue with the advent o f human immunodeficiency virus (HIV) infection. We report a 28-year-ol d Chinese man with recently acquired HIV infection together with early neurosyphilis. His presentation of acute mononucleosis-like syndrome, lymphadenopathy, aseptic meningitis, positive central nervous syndrom e and reactive Veneral Disease Research laboratory test in his cerebro spinal fluid helped to reach the diagnosis. Paired serum Western blot tests for HIV infection performed 1 month apart revealed either a new appearance or an increasing intensity of bands for p17, p24, p31, gp41 , p52, p55, p68, gp120 and gp160 suggesting recently acquired HIV infe ction. The lymphadenopathy disappeared spontaneously and the neurosyph ilis responded well to 14 days of penicillin G therapy. The Western bl ot pattern, clinical course, laboratory data, and therapeutic response indicated that the acute retroviral syndrome and early central nervou s system involvement caused by Treponema pallidum occurred concomitant ly.