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基于快速聚合酶链反应的艾滋病患者播散性组织胞浆菌病诊断

Rapid PCR-based diagnosis of disseminated histoplasmosis in an AIDS patient.

作者信息

Rickerts V, Bialek R, Tintelnot K, Jacobi V, Just-Nübling G

机构信息

Medizinische Klinik III/Infektiologie, Klinikum der J.W. Goethe Universität, Theodor Stern Kai 7, 60590 Frankfurt, Germany.

出版信息

Eur J Clin Microbiol Infect Dis. 2002 Nov;21(11):821-3. doi: 10.1007/s10096-002-0833-y. Epub 2002 Oct 31.

Abstract

Disseminated histoplasmosis is an unusual opportunistic infection in patients with advanced HIV infection living outside endemic areas. Diagnosis usually is made on the basis of isolation of Histoplasma capsulatum from clinical specimens or histologic examination. Reported is the case of an HIV-infected Columbian individual in whom the diagnosis of histoplasmosis was established within 24 h of collection of an adequate bronchoalveolar lavage specimen. The diagnosis was made by detection of specific fungal DNA and confirmed by isolation of Histoplasma capsulatum from blood, bone marrow and respiratory specimens 10 days later. The patient recovered under antifungal treatment and remained asymptomatic up to the last follow-up visit 6 months later. The polymerase chain reaction assay might be a powerful and rapid diagnostic tool for the diagnosis of non-European invasive fungal infections and should be further evaluated.

摘要

播散性组织胞浆菌病在非流行地区的晚期HIV感染患者中是一种不常见的机会性感染。诊断通常基于从临床标本中分离荚膜组织胞浆菌或组织学检查。报告了一例HIV感染的哥伦比亚人病例,在采集足够的支气管肺泡灌洗标本后24小时内确诊为组织胞浆菌病。诊断通过检测特定真菌DNA得出,并在10天后从血液、骨髓和呼吸道标本中分离出荚膜组织胞浆菌得到证实。患者在抗真菌治疗下康复,直到6个月后的最后一次随访仍无症状。聚合酶链反应检测可能是诊断非欧洲侵袭性真菌感染的一种强大而快速的诊断工具,应进一步评估。

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