Monill J M, Franquet T, Sambeat M A, Martínez-Noguera A, Villalba J
Department of Radiology, Hospital de Sant Pau, Universidad Autónoma de Barcelona, Spain.
Eur Radiol. 2001;11(2):193-6. doi: 10.1007/s003300000606.
This retrospective study included eight HIV-positive patients with a M. genavense infection. Seven of these patients had a CT scan of the abdomen and a US examination, whereas one patient with pulmonary symptoms had conventional chest radiographs and thin-section CT scan of the thorax. Multiple large retroperitoneal and mesenteric lymph nodes were demonstrated in seven patients; low-attenuation centers within enlarged nodes were identified in two patients. On CT scans two cases showed circumferential wall thickening of the proximal small bowel with a deep ulceration in one of these patients. Additional findings included focal lesions in the liver (n = 1), spleen (n = 2), splenomegaly (n = 6), and hepatomegaly (n = 4). The CT scans from the thoracic examination demonstrated multiple diffuse nodular infiltrates in both lungs. M. genavense infection should be considered in the differential diagnosis of AIDS patients with CD4 counts below 100 cells/mm3 presenting with abdominal lymphadenopathy, multinodular or homogeneous hepatosplenic enlargement and circumferential thickening of the small bowel wall.
这项回顾性研究纳入了8例感染日内瓦分枝杆菌的HIV阳性患者。其中7例患者进行了腹部CT扫描和超声检查,而1例有肺部症状的患者进行了胸部X线平片和胸部薄层CT扫描。7例患者显示多个腹膜后和肠系膜大淋巴结;2例患者肿大淋巴结内可见低密度中心。CT扫描显示2例患者近端小肠壁环形增厚,其中1例有深部溃疡。其他发现包括肝脏局灶性病变(n = 1)、脾脏局灶性病变(n = 2)、脾肿大(n = 6)和肝肿大(n = 4)。胸部检查的CT扫描显示双肺多发弥漫性结节状浸润。对于CD4细胞计数低于100个/mm3且出现腹部淋巴结病、多结节或均匀性肝脾肿大以及小肠壁环形增厚的艾滋病患者,鉴别诊断时应考虑日内瓦分枝杆菌感染。