Giancola Maria Letizia, Baldini Francesco, Carapella Carmine Maria, Busi Rizzi Elisa, Maddaluno Rita, Alba Lucia, Antinori Andrea
National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy.
J Infect Dev Ctries. 2015 May 18;9(5):536-40. doi: 10.3855/jidc.5552.
The case of an HIV-infected man from Eritrea previously diagnosed with tuberculosis, who presented neurological impairment and cerebral lesion after having voluntarily stopped anti-tubercular and antiretroviral therapies, is here reported. Treatments associated with steroids and mannitol were administered. The patient's condition improved, but neuroimaging showed a continuous worsening of the lesion, while a great immunological reconstitution was observed. Brain microsurgery was performed. A tuberculosis diagnosis was supported by pathological and microbiological examinations. Tuberculosis arising during immune reconstitution inflammatory syndrome is a complication of antiretroviral treatment and is considered to be an emerging disorder, especially in countries highly endemic for tuberculosis.
本文报告了一例来自厄立特里亚的艾滋病毒感染者，该男子先前被诊断患有结核病，在自愿停止抗结核和抗逆转录病毒治疗后出现神经功能障碍和脑部病变。给予了类固醇和甘露醇相关治疗。患者病情有所改善，但神经影像学显示病变持续恶化，同时观察到显著的免疫重建。进行了脑部显微手术。病理和微生物学检查支持结核病诊断。免疫重建炎症综合征期间出现的结核病是抗逆转录病毒治疗的一种并发症，被认为是一种新出现的疾病，尤其是在结核病高流行国家。
