Walldorf J, Lübbert C
Universitätsklinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale).
Z Gastroenterol. 2013 Aug;51(8):740-3. doi: 10.1055/s-0033-1335722. Epub 2013 Aug 16.
We report on a 30-year-old patient who presented with bloody diarrhoea. After initially, assuming a previously not diagnosed ulcerative colitis, an immunosuppressive therapy was initiated, a week later an HIV infection stage C2 according to the CDC classification, complicated by CMV viraemia, was diagnosed. In this case report the course of treatment with highly active antiretroviral therapy (HAART), ganciclovir and prednisolone is reported and discussed on the basis of histological, immunohistochemical and microbiological findings. The case illustrates the difficulty to distinguish between ulcerative colitis, immune reconstitution syndrome, CMV colitis and HIV-associated diarrhoea.
我们报告了一名30岁出现血性腹泻的患者。最初假定为先前未诊断出的溃疡性结肠炎，随后开始了免疫抑制治疗，一周后诊断出根据美国疾病控制与预防中心（CDC）分类为C2期的HIV感染，并伴有巨细胞病毒血症。在本病例报告中，根据组织学、免疫组化和微生物学检查结果，报告并讨论了高效抗逆转录病毒疗法（HAART）、更昔洛韦和泼尼松龙的治疗过程。该病例说明了区分溃疡性结肠炎、免疫重建综合征、巨细胞病毒性结肠炎和HIV相关性腹泻的困难。
