Ahuja T S, Remmers A, Rajaraman S, Funtanilla M
Department of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA.
Am J Kidney Dis. 1998 Jul;32(2):E3. doi: 10.1053/ajkd.1998.v32.pm10074611.
Although the most frequent cause of acute renal failure (ARF) in patients with AIDS is acute tubular necrosis (ATN) secondary to ischemic renal injury from septicemia, a spectrum of causes may result in ARF in these patients. We report a patient with AIDS who developed ARF and was found to have granulomatous interstitial nephritis as a result of disseminated histoplasmosis. Histoplasma capsulatum was seen in the interstitium of the kidney on renal biopsy. The patient was treated with amphotericin B and itraconazole. Although he continues to require hemodialysis 3 months after his initial presentation, his other presenting symptoms have resolved with antifungal therapy. We also discuss the literature on disseminated histoplasmosis and renal failure.
虽然艾滋病患者急性肾衰竭（ARF）最常见的病因是败血症导致缺血性肾损伤继发的急性肾小管坏死（ATN），但一系列病因都可能导致这些患者发生ARF。我们报告了一名艾滋病患者，该患者发生了ARF，经检查发现是播散性组织胞浆菌病导致的肉芽肿性间质性肾炎。肾活检显示肾脏间质中可见荚膜组织胞浆菌。该患者接受了两性霉素B和伊曲康唑治疗。虽然在初次就诊3个月后他仍需要进行血液透析，但抗真菌治疗已使他的其他症状得到缓解。我们还讨论了关于播散性组织胞浆菌病和肾衰竭的文献。
