Gardener T D, Flanagan P, Dryden M S, Costello C, Shanson D C, Gazzard B G
Department of Medicine, St Stephen's Hospital, London, U.K.
J Infect. 1988 Mar;16(2):135-40. doi: 10.1016/s0163-4453(88)93897-2.
During a period of 14 months in 1985 and 1986, infection with Mycobacterium avium-intracellulare (MAI) complex was diagnosed in 10 of 76 patients with Human Immunodeficiency Virus (HIV)-associated infection. In eight of the 10 patients, the infection was disseminated. All eight patients were anaemic. A bone marrow aspirate and/or trephine biopsy performed in six of them revealed evidence of red cell hypoplasia. MAI was cultured from all six samples of bone marrow. The strains of MAI isolated were resistant to conventional antituberculous drugs but were susceptible in vitro to ansamycin, ethionamide and cycloserine. None of the eight patients responded clinically to antituberculous therapy. The eight anaemic patients had pronounced constitutional symptoms. We suggest that severe anaemia and constitutional symptoms in patients with HIV-associated disease should prompt a search for evidence of disseminated MAI infection.
在1985年和1986年的14个月期间，76例人类免疫缺陷病毒（HIV）相关感染患者中有10例被诊断为鸟分枝杆菌-胞内分枝杆菌（MAI）复合体感染。10例患者中有8例感染呈播散性。所有8例患者均贫血。其中6例患者进行了骨髓穿刺和/或骨髓活检，结果显示有红细胞发育不全的证据。所有6份骨髓样本均培养出MAI。分离出的MAI菌株对传统抗结核药物耐药，但在体外对安莎霉素、乙硫异烟胺和环丝氨酸敏感。8例患者对抗结核治疗均无临床反应。这8例贫血患者有明显的全身症状。我们建议，HIV相关疾病患者出现严重贫血和全身症状时，应促使医生寻找播散性MAI感染的证据。
