Imoto E M, Stein R M, Shellito J E, Curtis J L
Medical Service, San Francisco Veterans Administration Medical Center, California.
Am Rev Respir Dis. 1990 Oct;142(4):884-6. doi: 10.1164/ajrccm/142.4.884.
Cytomegalovirus (CMV) infection in patients with the acquired immunodeficiency syndrome (AIDS) can present as either disseminated disease, pneumonitis, retinitis, gastroenteritis, neuropathy, or a subclinical infection. We report a patient whose initial manifestation of CMV infection was severe central airways obstruction due to necrotizing tracheitis. At bronchoscopy, the lesion appeared deeply ulcerated, distinctly different from previously described airway lesions in patients with AIDS. Mucosal biopsies showed characteristic intranuclear and intracytoplasmic inclusions and cultures yielded only CMV. The patient responded partially to ganciclovir, steroids, and antibiotics against suspected anaerobic superinfection but died as a result of central nervous system disease believed due to toxoplasmosis or lymphoma. CMV infection of the upper airway should be considered in the patient with AIDS presenting with atypical cough or stridor and ulcerated endobronchial lesions.
获得性免疫缺陷综合征（AIDS）患者的巨细胞病毒（CMV）感染可表现为播散性疾病、肺炎、视网膜炎、肠胃炎、神经病变或亚临床感染。我们报告了一名患者，其CMV感染的初始表现为坏死性气管炎导致的严重中央气道梗阻。在支气管镜检查时，病变呈现出深度溃疡，与先前描述的AIDS患者气道病变明显不同。黏膜活检显示有特征性的核内和胞质内包涵体，培养仅分离出CMV。患者对更昔洛韦、类固醇以及针对疑似厌氧重叠感染的抗生素治疗有部分反应，但最终因认为是由弓形虫病或淋巴瘤导致的中枢神经系统疾病而死亡。对于出现非典型咳嗽或喘鸣以及支气管内溃疡病变的AIDS患者，应考虑上呼吸道CMV感染。
