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在一名近期开始接受抗逆转录病毒治疗的患者中发现组织胞浆菌病免疫重建炎症综合征。

Unmasking histoplasmosis immune reconstitution inflammatory syndrome in a patient recently started on antiretroviral therapy.

作者信息

Kiggundu Reuben, Nabeta Henry W, Okia Richard, Rhein Joshua, Lukande Robert

机构信息

College of Health Sciences - Infectious Disease Institute - Makerere University, Kampala - Uganda .

College of Health Sciences - School of Medicine - Makerere University, Kampala - Uganda .

出版信息

Autops Case Rep. 2016 Dec 30;6(4):27-33. doi: 10.4322/acr.2016.048. eCollection 2016 Oct-Dec.

DOI:10.4322/acr.2016.048
PMID:28210571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5304559/
Abstract

Histoplasmosis is the most common endemic mycoses among HIV-infected people. Patients with suppressed cell immunity mainly due to HIV are at increased risk of disseminated disease. Dermatological manifestations of immune reconstitution inflammatory syndrome (IRIS) and cutaneous manifestations of histoplasmosis similar to an IRIS event have been previously described. We report the case of a 43-year-old male who presented with cutaneous disseminated histoplasmosis due to var. 4 months after the onset of the antiretroviral therapy and some improvement in the immune reconstitution. After 2 weeks of amphotericin B and itraconazole therapy, the scheduled treatment involved fluconazole maintenance therapy, which resulted in an improvement of his skin lesions.

摘要

组织胞浆菌病是HIV感染者中最常见的地方性真菌病。主要因HIV导致细胞免疫抑制的患者发生播散性疾病的风险增加。免疫重建炎症综合征（IRIS）的皮肤表现以及类似于IRIS事件的组织胞浆菌病皮肤表现此前已有描述。我们报告一例43岁男性病例，该患者在开始抗逆转录病毒治疗4个月后出现皮肤播散性组织胞浆菌病（变种），且免疫重建有一定改善。在两性霉素B和伊曲康唑治疗2周后，后续计划采用氟康唑维持治疗，其皮肤病变有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/db910bf3d814/autopsy-06-04027-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/465edde794d7/autopsy-06-04027-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/83602cf3fc23/autopsy-06-04027-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/c44d982b8500/autopsy-06-04027-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/db910bf3d814/autopsy-06-04027-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/465edde794d7/autopsy-06-04027-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/83602cf3fc23/autopsy-06-04027-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/c44d982b8500/autopsy-06-04027-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45d/5304559/db910bf3d814/autopsy-06-04027-g04.jpg

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