晚期人类免疫缺陷病毒/获得性免疫综合征中的巨细胞病毒血管炎与毛霉菌病合并感染

Cytomegalovirus vasculitis and mucormycosis coinfection in late-stage HIV/AIDS.

作者信息

Samant Jyoti S, Namgoong Soo H, Parveen Talat, Katner Harold P

机构信息

Department of Internal Medicine, Section of Infectious Diseases, Mercer University, School of Medicine, Macon, Georgia 31201, USA.

出版信息

Am J Med Sci. 2007 Feb;333(2):122-4. doi: 10.1097/00000441-200702000-00011.

DOI:10.1097/00000441-200702000-00011

PMID:17301593

Abstract

Case reports have previously been published describing various complications of cytomegalovirus (CMV) and mucormycosis in patients with HIV/AIDS. We describe the first case of CMV vasculitis and mucormycosis coinfection resulting in necrotizing myofascial cellulitis in an extremity in late stage HIV/AIDS. In AIDS patients, CMV reactivates when the CD4 count falls to less than 50 cells/microL (normal, 720-1440 cells/microL). Transient episodes of neutropenia in patients with HIV/AIDS who have low CD 4 cell counts are a predisposing factor for mucormycosis. These predisposing conditions were both present in our patient. Our case raises the question of CMV vasculitis leading to tissue ischemia as a possible contributing factor to the mucormycosis superinfection.

摘要

此前已有病例报告描述了艾滋病患者中巨细胞病毒（CMV）和毛霉菌病的各种并发症。我们报告了首例晚期艾滋病患者发生巨细胞病毒血管炎与毛霉菌病合并感染，导致肢体坏死性肌筋膜蜂窝织炎的病例。在艾滋病患者中，当CD4细胞计数降至低于50个/微升（正常为720 - 1440个/微升）时，巨细胞病毒会重新激活。CD4细胞计数低的艾滋病患者出现的短暂中性粒细胞减少发作是毛霉菌病的一个诱发因素。我们的患者同时存在这些诱发情况。我们的病例提出了一个问题，即巨细胞病毒血管炎导致组织缺血是否可能是毛霉菌病重叠感染的一个促成因素。