Low back pain and fever as the first symptoms of AIDS: case report

Abstract

Each year, the number of acquired immunodeficiency syndrome (AIDS) cases increases significantly. The first symptoms of HIV infection can be variable, which difficulties the diagnosis at this stage. We report the case of a male patient, 46 year-old, presenting lumbar pain and fever for five days, no more complaints. Neurological examination and computed tomography (CT) of the lumbar spine normal. Serology for HIV showed positive. It started antiretroviral therapy obtaining resolution of the previous condition. The majority of HIV-infected patients present acute retroviral syndrome (ARS) early in infection. This syndrome includes nonspecific symptoms as fever, fatigue, arthralgia, myalgia, headache and anorexia. In seropositive patients, pain is a common symptom, bur poorly treated. The pain main appear in all stages of the disease, more frequent in advanced ones. The main sites of pain are head, legs and lower back. The symptomatic treatment of pain should be initiated quickly, even though the etiology is not possible. The treatment of pain in HIV patients may be diverse and requires polytherapy in most of cases. It is necessary to keep a high level of suspicion in all patients who presents compatible symptoms and reports recent risk behaviors. The early diagnosis and treatment are the key to good quality of life for these patients.

Keywords

• acquired immunodeficiency syndrome
• diagnosis
• low back pain