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一例合并获得性免疫缺陷综合征的肝结核病例。

A case of hepatic tuberculosis with acquired immune deficiency syndrome.

作者信息

Liu Yanbin, Guo Wei, Gao Shicheng, Luo Mingqi, Liang Ke

机构信息

Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan University, Hubei, China.

Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China; Department of Pathology, School of Basic Medical Sciences, Wuhan University, Wuhan, China.

出版信息

Am J Med Sci. 2022 Jun;363(6):552-555. doi: 10.1016/j.amjms.2021.10.032. Epub 2022 Mar 14.

Abstract

Hepatic tuberculosis (TB) is a rare type of extrapulmonary TB. Due to the nonspecific clinical symptoms and imaging manifestations, hepatic TB with human immunodeficiency virus (HIV) infection is easy to be misdiagnosed. We report a case of hepatic TB with acquired immune deficiency syndrome (AIDS), which was initially misdiagnosed as general bacterial liver abscess even after the patient received needle biopsy. In subsequent process, pathogenic tests using washing solution of punctured liver tissue sample were proved feasible, convenient, and specific for pathogenic diagnosis in resource-limited areas of China. For liver abscess in patients with HIV, the pathogens are more complex than HIV negative patients. Some uncommon pathogens, such as TB and fungi, should also be taken into consideration. For the hepatic TB without abscess formation, pathogenic test using washing solution of punctured liver tissue sample should be attached importance.

摘要

肝结核是一种罕见的肺外结核类型。由于其临床症状和影像学表现不具有特异性,合并人类免疫缺陷病毒(HIV)感染的肝结核容易被误诊。我们报告一例获得性免疫缺陷综合征(AIDS)合并肝结核的病例,该患者即使在接受穿刺活检后最初仍被误诊为普通细菌性肝脓肿。在后续过程中,使用穿刺肝组织样本洗涤液进行病原学检测在中国资源有限地区被证明对病原学诊断可行、便捷且具有特异性。对于HIV患者的肝脓肿,其病原体比HIV阴性患者更为复杂。一些不常见的病原体,如结核和真菌,也应予以考虑。对于未形成脓肿的肝结核,应重视使用穿刺肝组织样本洗涤液进行病原学检测。

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A case of hepatic tuberculosis with acquired immune deficiency syndrome.一例合并获得性免疫缺陷综合征的肝结核病例。
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