免疫功能低下人群中非肠道原生动物感染的重要性。
Importance of nonenteric protozoan infections in immunocompromised people.
机构信息
Department of Microbiology, St. Vincent's Hospital, Darlinghurst 2010, NSW, Australia.
出版信息
Clin Microbiol Rev. 2010 Oct;23(4):795-836. doi: 10.1128/CMR.00001-10.
There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.
有许多被忽视的非肠道原生动物能够在人类中引起严重的发病率和死亡率,特别是在发展中国家。在 HIV 存在的情况下,某些原生动物引起的疾病通常更为严重。虽然有关引起热带病的锥虫和疟原虫的信息很丰富,但在这些原生动物非地方性流行的西方国家,它们通常不是首要考虑因素。因此,这些地区可能没有诊断方法。由于全球旅行和移民,这已成为一个日益严重的问题。相反,在世界某些地区(特别是撒哈拉以南非洲),HIV 问题非常严重,微孢子虫病和弓形体病等疾病很常见。在西方国家,由于高效抗逆转录病毒疗法(HAART)的可用性,这些疾病很少见。虽然自由生活的阿米巴原虫在临床环境中很少见,但当感染发生时,它们通常是致命的。快速诊断和治疗对于感染这些生物体的患者的生存至关重要。本文综述了免疫功能低下者中非肠道原生动物病的诊断和治疗信息,重点是感染 HIV 的患者。讨论了非肠道微孢子虫、某些锥虫、弓形虫、新孢子虫、某些自由生活的阿米巴原虫、疟原虫和巴贝虫。
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