Tandon Richa, Kim Kye S, Serrao Richard
Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA.
AIDS Read. 2007 Nov;17(11):555-60.
We present the case of a 55-year-old-man with AIDS who had disseminated Mycobacterium avium-intracellulare (MAI) infection who was nonadherent to antiretroviral treatment and prophylaxis for opportunistic infections. The patient acquired HIV via intravenous drug sue; he had a CD4+ cell count of 4/microL (1%) and an HIV RNA level of 114,000 copies/mL at the time of his HIV diagnosis. He presented with MAI bacteremia and had rapidly evolving and resolving cutaneous lesions caused by MAI. Concomitant nonspecific brain lesions presented a diagnostic challenge, but they improved with MAI treatment. In persons with HIV/AIDS who have cutaneous lesions, biopsy of superficial lesions has proved helpful. MAI infection should be considered in the differential diagnosis of cutaneous and brain lesions in persons with HIV/AIDS.
我们报告了一例55岁的艾滋病男性患者，其患有播散性鸟分枝杆菌-胞内分枝杆菌（MAI）感染，未坚持抗逆转录病毒治疗及机会性感染的预防措施。该患者通过静脉注射毒品感染了HIV；在其被诊断为HIV时，CD4 +细胞计数为4/μL（1%），HIV RNA水平为114,000拷贝/mL。他出现了MAI菌血症，并伴有由MAI引起的迅速演变且自行消退的皮肤病变。同时出现的非特异性脑病变带来了诊断挑战，但经MAI治疗后有所改善。对于患有皮肤病变的HIV/AIDS患者，浅表病变活检已被证明是有帮助的。在HIV/AIDS患者皮肤和脑病变的鉴别诊断中应考虑MAI感染。
