Heise W, Mostertz P, Arasteh K, Skörde J, L'age M
II. Innere Abteilung (Infektiologie und Gastroenterologie), Auguste-Viktoria-Krankenhaus, Berlin-Schöneberg.
Dtsch Med Wochenschr. 1988 Oct 14;113(41):1588-93. doi: 10.1055/s-2008-1067854.
Among 200 hospitalized patients treated for HIV infections there were 98 with gastrointestinal symptoms, independent of the stage of the disease. Only 22 had abnormal stool findings. But histological examination and culture of endoscopically obtained biopsies revealed opportunistic infection in 62, of whom 28 had a cytomegalovirus infection. Mycobacterium avium-intracellulare was found in the gastrointestinal mucosa of 25 patients, but its clinical significance is unclear. In 33 of the 98 patients previously classified as positive for HIV or AIDS-related complex, endoscopic demonstration of an opportunistic infection required amendment of their HIV stage. In over 60% endoscopy revealed mucosal changes. A distinction from Crohn's disease or ulcerative colitis could only be made by histology or exclusion of the causative microorganism. Demonstration of the causative microorganism from the biopsy is thus essential in patients with gastrointestinal symptoms, because specific treatment is in principle possible and successful for some opportunistic infections.
在200名因感染HIV而住院治疗的患者中，有98名出现胃肠道症状，与疾病阶段无关。只有22名患者粪便检查结果异常。但对内镜获取的活检组织进行组织学检查和培养发现，62名患者存在机会性感染，其中28名感染了巨细胞病毒。25名患者的胃肠道黏膜中发现了鸟分枝杆菌复合群，但其临床意义尚不清楚。在之前被归类为HIV阳性或艾滋病相关综合征阳性的98名患者中，有33名患者通过内镜检查发现机会性感染后，其HIV分期需要修正。超过60%的患者内镜检查显示有黏膜改变。只有通过组织学检查或排除致病微生物，才能将其与克罗恩病或溃疡性结肠炎区分开来。因此，对于有胃肠道症状的患者，从活检组织中检测出致病微生物至关重要，因为对于某些机会性感染，原则上可以进行特异性治疗并取得成功。
