Kadende P, Nkurunziza T, Floch J J, Mpfizi B, Laroche R, Ndabaneze E, Aubry P
Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi.
Med Trop (Mars). 1989 Apr-Jun;49(2):129-33.
The authors carried out a prospective survey on 100 cases of AIDS in order to find out the different etiologies of infections diarrhoea in terms of frequency and diagnosis behaviour. 84 out of 100 patients got diarrhoea. All 100 patients had their stools examined, 78 underwent high digestive fibroscopy with irrigation and aspiration of duodenal liquid (IADL), 40 duodenal biopsies. 98 infecting agents were revealed in stool exams, 50 in IADL, 7 at the occasion of histopathological exam of duodenal biopsies. All together, stool exams and IADL gave evidence that Isospora belli and Cryptosporidium are the opportunistic infecting agents most often revealed (16.2 and 13.1 p.c., respectively). The role of yeasts in diarrhoea is not evident, but esophageal candidosis is the most frequent opportunistic digestive infection (48 p.c.). Anguillula is the only intestinal worm appearing to play a role: the role of bacteria and viruses cannot be evaluated precisely, but histopathological study revealed neither an atypical mycobacteriosis nor a virus disease (herpes, cytomegalovirus). If diagnosis appears to be still difficult in 1989 when confronted with AIDS and diarrhoea, it seems highly advisable to examine the stools, to perform high digestive fibroscopy with IADL and biopsies. On the other hand, indications for colonoscopy appear to be restricted.
作者对100例艾滋病患者进行了前瞻性调查，以便从感染频率和诊断行为方面找出感染性腹泻的不同病因。100例患者中有84例出现腹泻。所有100例患者均进行了粪便检查，78例接受了高消化纤维内镜检查并进行十二指肠液冲洗和抽吸（IADL），40例进行了十二指肠活检。粪便检查发现98种感染因子，IADL检查发现50种，十二指肠活检组织病理学检查发现7种。粪便检查和IADL检查共同表明，贝氏等孢球虫和隐孢子虫是最常发现的机会性感染因子（分别为16.2%和13.1%）。酵母菌在腹泻中的作用不明显，但食管念珠菌病是最常见的机会性消化系统感染（48%）。粪类圆线虫是唯一似乎起作用的肠道蠕虫：细菌和病毒的作用无法精确评估，但组织病理学研究未发现非典型分枝杆菌病或病毒病（疱疹、巨细胞病毒）。1989年，当面对艾滋病和腹泻时，诊断似乎仍然困难，此时检查粪便、进行IADL高消化纤维内镜检查和活检似乎是非常可取的。另一方面，结肠镜检查的适应证似乎有限。
