Skalski Joseph H, Limper Andrew H
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Semin Respir Crit Care Med. 2016 Apr;37(2):257-66. doi: 10.1055/s-0036-1578802. Epub 2016 Mar 14.
Respiratory illness is an important cause of morbidity and mortality in patients with human immunodeficiency virus (HIV). The spectrum of pulmonary disease that can affect patients with HIV is wide and includes opportunistic infection with many fungal, viral, and parasitic organisms. This article reviews the clinical presentation; approach to diagnosis; and management of fungal, viral, and parasitic pneumonias that can develop in patients with HIV including respiratory disease caused by Aspergillus, Cryptococcus, Histoplasma, Coccidioides, Cytomegalovirus, Toxoplasma, and Strongyloides. Because clinical symptoms and radiographic patterns are often insensitive at distinguishing these pulmonary infections, this review particularly focuses on specific host risk factors and diagnostic testing to consider when approaching HIV patients with respiratory illness.
呼吸系统疾病是人类免疫缺陷病毒（HIV）感染者发病和死亡的重要原因。可影响HIV感染者的肺部疾病谱广泛，包括多种真菌、病毒和寄生虫病原体引起的机会性感染。本文综述了HIV感染者可能发生的真菌、病毒和寄生虫性肺炎的临床表现、诊断方法及治疗，包括由曲霉菌、隐球菌、组织胞浆菌、球孢子菌、巨细胞病毒、弓形虫和粪类圆线虫引起的呼吸系统疾病。由于临床症状和影像学表现往往对鉴别这些肺部感染不敏感，本综述特别关注在诊治患有呼吸系统疾病的HIV患者时应考虑的特定宿主危险因素和诊断检测。
