Pallangyo K, Håkanson A, Lema L, Arris E, Mteza I, Pålsson K, Yangi E, Mhalu F, Biberfeld G, Britton S
Department of Internal Medicine, Muhimbili Medical Centre, University of Dar es Salaam, Tanzania.
AIDS. 1992 Sep;6(9):971-6. doi: 10.1097/00002030-199209000-00010.
To correlate deep bacterial infections with HIV infection and evaluate the influence of HIV on clinical picture and outcome in patients with meningitis, pneumonia or pyomyositis.
Case-control comparison of HIV seroprevalence between patients and an age- and sex-matched control group in a prospective cross-sectional study of hospitalized patients.
One hundred and sixty-five patients admitted to hospital with either purulent meningitis, pneumonia or pyomyositis and 165 age- and sex-matched controls from orthopaedic/trauma wards.
University Hospital, Dar es Salaam, Tanzania.
Differences in HIV seroprevalence and mortality.
Of 78 patients with purulent meningitis, 19 (24%) were HIV-seropositive, compared with 13 (17%) in the control group (P = 0.345). Of 36 patients with meningitis seen before a meningococcal epidemic affected Dar es Salaam, there was a statistically significant association with HIV infection (P = 0.013). Ten out of 19 (53%) HIV-seropositives died, compared with nine out of 59 (15%) seronegatives (P = 0.028). Of patients with pneumococcal meningitis, five out of six (83%) seropositives died, compared with two out of 12 (17%) seronegatives (P = 0.013). Fifteen out of 45 (33%) patients with pneumonia were HIV-seropositive, compared with four (9%) in the control group (P = 0.001). There was no difference in mortality between seropositive and seronegative patients with pneumonia. HIV seroprevalence was 62% among 42 patients with pyomyositis and 12% among 42 controls (P less than 0.0001). Eighteen out of 25 (72%) seropositive patients with pyomyositis fulfilled the World Health Organization (WHO) clinical case definition for AIDS. Response to recommended antibiotic treatment was satisfactory among patients with pneumonia and pyomyositis.
These results show a strong association between pyomyositis, pneumonia and HIV infection. They also indicate an increased mortality associated with HIV infection in patients with pyogenic meningitis, especially pneumococcal meningitis. Pyomyositis should be considered an indicator of stage III HIV disease in the proposed WHO clinical staging system.
将深部细菌感染与HIV感染相关联，并评估HIV对脑膜炎、肺炎或脓性肌炎患者临床表现及预后的影响。
在一项针对住院患者的前瞻性横断面研究中，对患者与年龄及性别匹配的对照组进行HIV血清阳性率的病例对照比较。
165例因化脓性脑膜炎、肺炎或脓性肌炎入院的患者，以及来自骨科/创伤病房的165例年龄及性别匹配的对照者。
坦桑尼亚达累斯萨拉姆大学医院。
HIV血清阳性率及死亡率的差异。
78例化脓性脑膜炎患者中，19例（24%）HIV血清阳性，而对照组为13例（17%）（P = 0.345）。在达累斯萨拉姆脑膜炎球菌流行之前诊治的36例脑膜炎患者中，与HIV感染存在统计学显著关联（P = 0.013）。19例HIV血清阳性患者中有10例（53%）死亡，而59例血清阴性患者中有9例（15%）死亡（P = 0.028）。肺炎球菌脑膜炎患者中，6例血清阳性患者中有5例（83%）死亡，而12例血清阴性患者中有2例（17%）死亡（P = 0.013）。45例肺炎患者中有15例（33%）HIV血清阳性，而对照组为4例（9%）（P = 0.001）。肺炎血清阳性和血清阴性患者的死亡率无差异。42例脓性肌炎患者中HIV血清阳性率为62%，42例对照者中为12%（P<0.0001）。25例血清阳性脓性肌炎患者中有18例（72%）符合世界卫生组织（WHO）艾滋病临床病例定义。肺炎和脓性肌炎患者对推荐抗生素治疗的反应令人满意。
这些结果表明脓性肌炎、肺炎与HIV感染之间存在密切关联。它们还表明化脓性脑膜炎患者，尤其是肺炎球菌脑膜炎患者中，与HIV感染相关的死亡率增加。在WHO提议的临床分期系统中，脓性肌炎应被视为HIV疾病Ⅲ期的一个指标。
