Graham A R, Sobonya R E, Bronnimann D A, Galgiani J N
Dept of Pathology, University of Arizona Health Sciences Center, Tucson 85724.
Hum Pathol. 1988 Jul;19(7):800-6. doi: 10.1016/s0046-8177(88)80263-6.
This study examines the laboratory aspects of diagnosis of coccidioidomycosis in 11 patients with acquired immunodeficiency syndrome (AIDS) and the qualitative and quantitative differences between host responses of AIDS and non-AIDS patients who died with disseminated coccidioidomycosis. Material obtained at bronchoscopy confirmed the diagnosis of pulmonary coccidioidomycosis in 67% (6/9) of the patients. Patients with AIDS had a generally poor granulomatous response and statistically significantly increased numbers of spherules in lung tissue compared with non-AIDS patients. Neither antifungal therapy nor duration of clinical disease influenced the number of organisms present. The findings suggest a parallel between AIDS-associated coccidioidomycosis and other granulomatous diseases such as leprosy and schistosomiasis, in which the type of granuloma formation and organism numbers are influenced by the T-lymphocyte milieu.
本研究调查了11例获得性免疫缺陷综合征（AIDS）患者球孢子菌病诊断的实验室相关情况，以及死于播散性球孢子菌病的AIDS患者与非AIDS患者宿主反应在定性和定量方面的差异。支气管镜检查获取的材料证实，67%（6/9）的患者诊断为肺球孢子菌病。与非AIDS患者相比，AIDS患者的肉芽肿反应总体较差，肺组织中的球形体数量在统计学上显著增加。抗真菌治疗和临床疾病持续时间均未影响病原体数量。这些发现表明，AIDS相关的球孢子菌病与其他肉芽肿性疾病（如麻风病和血吸虫病）存在相似之处，在这些疾病中，肉芽肿形成类型和病原体数量受T淋巴细胞环境的影响。
