人类免疫缺陷病毒感染中的肺外结核病
Extrapulmonary Tuberculosis in Human Immunodificiency Virus Infection.
作者信息
Barthwal M S, Rajan K E, Deoskar R B, Sharma S K
机构信息
Classified Specialist(Medicine) MH Namkum.
Senior Advisor(Medicine and Respiratory Medicine), Military Hospital (CTC), Pune-40.
出版信息
Med J Armed Forces India. 2005 Oct;61(4):340-1. doi: 10.1016/S0377-1237(05)80059-0. Epub 2011 Jul 21.
BACKGROUND
In view of increase in incidence of exptrapulmonary tuberculosis after the epidemic of human immunodeficiency virus infection, the clinical profile of extrapulmonary tuberculosis in patients with HIV infection was studied.
METHOD
The study population comprised patients of HIV infection with extrapulmonary tuberculosis. Work up included history, clinical examination, sputum for acid fast bacilli, chext X-ray, ultrasonography (USG) abdomen, fine needle aspiration cytology(FNAC), transbronchial needle aspiration (TBNA) and computed tomography of chest.
RESULTS
There were 50 cases, all males with mean age of 35 years. 24(48%) were without pulmonary tuberculosis and 26(52%) had pulmonary tuberculosis. 41(82%) had disseminated disease and 9(18%) involve one site. Fever and weight loss were the most frequent symptoms (79% and 58% respectively) in cases without pulmonary tuberculosis. The most frequent extrapulmonary site was lymph node in 46(92%), followed by spleen in 13(26%), pleura 9(18%), miliary 7(14%) and hepatic 1(2%). The diagnosis was confirmed by invasive methods in 30 out of 50(60%) cases [FNAC in 23(88%), TBNA in 2(25%) and pleural biopsy in 5(55%)].
CONCLUSION
In HIV infected patients, the most common extrapulmonary site is lymph mode followed by spleen.
背景
鉴于人类免疫缺陷病毒感染流行后肺外结核病发病率上升，对HIV感染患者的肺外结核病临床特征进行了研究。
方法
研究人群包括患有肺外结核病的HIV感染患者。检查包括病史、临床检查、痰找抗酸杆菌、胸部X线、腹部超声（USG）、细针穿刺细胞学检查（FNAC）、经支气管针吸活检（TBNA）和胸部计算机断层扫描。
结果
共50例，均为男性，平均年龄35岁。24例（48%）无肺结核，26例（52%）有肺结核。41例（82%）为播散性疾病，9例（18%）累及一个部位。无肺结核患者中最常见的症状是发热和体重减轻（分别为79%和58%）。最常见的肺外部位是淋巴结，共46例（92%），其次是脾脏13例（26%）、胸膜9例（18%）、粟粒样病变7例（14%）和肝脏1例（2%）。50例中有30例（60%）通过侵入性方法确诊[FNAC确诊23例（88%）、TBNA确诊2例（25%）、胸膜活检确诊5例（55%）]。
结论
在HIV感染患者中，最常见的肺外部位是淋巴结，其次是脾脏。
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