Kielhofner M, Atmar R L, Hamill R J, Musher D M
Medical Service (Infectious Disease Section), Houston Veterans Affairs Medical Center, Texas 77030.
Clin Infect Dis. 1992 Feb;14(2):403-11. doi: 10.1093/clinids/14.2.403.
Bacterial infections are a well-described complication of AIDS. However, relatively few reports have described infections due to Pseudomonas aeruginosa in adults who are infected with the human immunodeficiency virus (HIV). Seven cases of serious P. aeruginosa infection in HIV-infected patients occurred during 12 months in two hospitals in Houston, often in the absence of other host factors that are generally thought to predispose to this condition. One patient had no prior illness or antibody test results that were suggestive of HIV infection; for two other patients who were known to have antibody to HIV, an AIDS-defining diagnosis had never been made. Three patients had pneumonia (two with bacteremia and one with empyema), one had malignant otitis externa, and three had bacteremia that either resulted from or caused secondarily a soft-tissue focus of infection. Two patients died, and two others experienced one or more relapses after an initial course of treatment. Compromised host defense mechanisms, including loss of mucosal integrity, defects in humoral and cellular immunities, and qualitative or quantitative leukocyte abnormalities, may predispose HIV-infected patients to P. aeruginosa infections.
细菌感染是艾滋病一种广为人知的并发症。然而，相对较少的报告描述了人类免疫缺陷病毒（HIV）感染成人中由铜绿假单胞菌引起的感染。在休斯顿的两家医院，12个月内发生了7例HIV感染患者的严重铜绿假单胞菌感染病例，且往往不存在通常认为易引发这种情况的其他宿主因素。一名患者既往无疾病史或抗体检测结果提示HIV感染；另外两名已知有HIV抗体的患者从未被作出艾滋病确诊诊断。3例患者患有肺炎（2例伴有菌血症，1例伴有脓胸），1例患有恶性外耳道炎，3例患有菌血症，这些菌血症要么由软组织感染灶引起，要么继发于软组织感染灶。2例患者死亡，另外2例在初始治疗疗程后经历了一次或多次复发。包括黏膜完整性丧失、体液和细胞免疫缺陷以及白细胞质或量的异常在内的宿主防御机制受损，可能使HIV感染患者易患铜绿假单胞菌感染。
