Hirasaki S, Koide N, Ogawa H, Tsuji T
First Department of Internal Medicine, Okayama University School of Medicine, Japan.
J Gastroenterol. 2000;35(1):47-51. doi: 10.1007/pl00009975.
We describe a case of intestinal tuberculosis and esophageal candidiasis in an 85-year-old Japanese woman with idiopathic CD4+ T-lymphocytopenia (ICL). The patient exhibited clinical symptoms of odynophagia, bloody diarrhea, and high fever. Physical examination on admission showed a poor nutritional status. Endoscopic examination of the upper digestive tract revealed the esophageal mucosa to be covered with yellowish-white plaque-like lesions. Colonoscopic examination revealed multiple annular ulcerations with bleeding. She was diagnosed with intestinal tuberculosis by polymerase chain reaction (PCR) and fecal culture. Her CD4+ T-lymphocyte count was 178/mm3 and no evidence of human immunodeficiency virus (HIV) infection was found. She was successfully treated with fluconazole and antituberculosis drugs. This case emphasizes the importance of opportunistic infections in elderly patients with predisposing conditions such as ICL.
我们描述了一例85岁日本女性患有特发性CD4 + T淋巴细胞减少症（ICL）并发肠道结核和食管念珠菌病的病例。患者表现出吞咽痛、血性腹泻和高热等临床症状。入院时体格检查显示营养状况较差。上消化道内镜检查发现食管黏膜覆盖有黄白色斑块样病变。结肠镜检查发现多处环形溃疡伴出血。通过聚合酶链反应（PCR）和粪便培养，她被诊断为肠道结核。她的CD4 + T淋巴细胞计数为178/mm3，未发现人类免疫缺陷病毒（HIV）感染的证据。她接受氟康唑和抗结核药物治疗后康复。该病例强调了在患有ICL等易感疾病的老年患者中机会性感染的重要性。
