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脾脏感染中的免疫重建炎症综合征:一例报告。

Immune reconstitution inflammatory syndrome in splenic infection: A case report.

作者信息

Kojima Hiroki, Tanaka Masaru, Imamura Akifumi

机构信息

Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Hon-komagome, Bunkyo-ku, Tokyo 113-8677, Japan.

Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan.

出版信息

IDCases. 2023 Feb 28;31:e01729. doi: 10.1016/j.idcr.2023.e01729. eCollection 2023.

Abstract

To the best of our knowledge, the present report is the first to describe immune reconstitution inflammatory syndrome (IRIS) in a case of () infection of the spleen. A 45-year-old, men who have sex with men patient presented with constipation, abdominal pain, nausea, fever, and weight loss. Human immunodeficiency virus infection and pneumonia were diagnosed. Abdominal computed tomography revealed multiple, hypodense, cystic lesions in the spleen. Based on the histopathological findings of the lesion obtained from a percutaneous splenic biopsy, extrapulmonary infection of the spleen was diagnosed. Trimethoprim/sulfamethoxazole was administered for 21 days, and antiretroviral therapy was initiated ten days after the former regimen was begun. Temporary enlargement of the splenic lesions and fever recurrence were observed after the trimethoprim/sulfamethoxazole regimen was completed. However, the clinical course was favorable, with no splenic rupture or splenic bleeding. Our investigation suggested that additional therapy, such as corticosteroid administration, may not be required for IRIS in a splenic infection, but further research is needed for a definitive conclusion.

摘要

据我们所知,本报告是首例描述脾()感染中免疫重建炎症综合征(IRIS)的病例。一名45岁的男同性恋患者出现便秘、腹痛、恶心、发热和体重减轻症状。诊断为人类免疫缺陷病毒感染和肺炎。腹部计算机断层扫描显示脾脏有多个低密度囊性病变。根据经皮脾活检获得的病变组织病理学结果,诊断为脾肺外()感染。给予复方新诺明治疗21天,并在前一疗程开始10天后开始抗逆转录病毒治疗。复方新诺明疗程结束后,观察到脾脏病变暂时增大和发热复发。然而,临床过程良好,未发生脾破裂或脾出血。我们的研究表明,脾()感染中的IRIS可能不需要额外的治疗,如使用皮质类固醇,但需要进一步研究才能得出明确结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5417/10009051/59d635cbad74/gr1.jpg

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