AIDS Clinical Center of the National Center for Global Health and Medicine, Japan.
Intern Med. 2022 Jan 15;61(2):257-261. doi: 10.2169/internalmedicine.7282-21. Epub 2021 Jul 30.
Cytopenia is a common complication in patients with human immunodeficiency virus (HIV) infection. Identifying the cause is demanding because of the wide range of possible diagnoses. We herein report an HIV-infected patient with disseminated cryptococcosis involving multiple organs including the blood, brain, lungs, and bone marrow, who developed progressive pancytopenia after initiation of anti-fungal treatment with liposomal amphotericin-B (L-AMB) and flucytosine (5FC). The pancytopenia persisted despite early 5FC discontinuation. A bone marrow biopsy revealed cryptococcal infiltration and the blood examination findings recovered quickly after resuming L-AMB. Thus, this HIV-infected patient's pathological findings and clinical course suggested that the primary cause of the pancytopenia was bone marrow cryptococcosis.
血细胞减少症是人类免疫缺陷病毒（HIV）感染患者的常见并发症。由于可能的诊断范围广泛，确定病因具有挑战性。本文报告了 1 例 HIV 感染患者，该患者患有播散性隐球菌病，累及多个器官，包括血液、大脑、肺部和骨髓，在开始用两性霉素 B 脂质体（L-AMB）和氟胞嘧啶（5FC）进行抗真菌治疗后，出现进行性全血细胞减少症。尽管早期停用 5FC，但全血细胞减少症仍持续存在。骨髓活检显示隐球菌浸润，恢复使用 L-AMB 后血液检查结果迅速恢复。因此，该 HIV 感染患者的病理发现和临床过程提示全血细胞减少症的主要原因是骨髓隐球菌病。
