Marinelli D L, Albelda S M, Williams T M, Kern J A, Iozzo R V, Miller W T
Radiology. 1986 Jul;160(1):77-82. doi: 10.1148/radiology.160.1.3715048.
The medical records, radiographs, and pathologic specimens of ten patients with the diagnoses of nontuberculous mycobacterial infection and acquired immunodeficiency syndrome (AIDS) were examined. The radiographic findings of alveolar or nodular infiltrates and adenopathy were relatively nonspecific but in most cases led to bronchoscopic study or open-lung biopsy, which established the diagnosis. Bronchoscopic washings or sputum cultures, which frequently provided the first confirmation of infection, were always followed by positive blood or tissue cultures. In contrast to nontuberculous infection in immunocompetent hosts, disseminated infection was common, with evidence of extrapulmonary involvement in nine patients. On the basis of these findings, we recommend that any AIDS patient with sputum or bronchoscopic washings demonstrating nontuberculous mycobacterial organisms be tentatively classified as having disseminated infection while being evaluated with blood, bone-marrow, stool, and urine cultures, even if the chest radiograph shows no disease.
对10例诊断为非结核分枝杆菌感染和获得性免疫缺陷综合征（AIDS）患者的病历、X线片和病理标本进行了检查。肺泡或结节状浸润及淋巴结病的X线表现相对不具特异性，但在大多数情况下会导致进行支气管镜检查或开胸肺活检，从而确立诊断。支气管镜冲洗液或痰培养常是感染的首次确诊依据，随后血培养或组织培养总是呈阳性。与免疫功能正常宿主的非结核感染不同，播散性感染很常见，9例患者有肺外受累的证据。基于这些发现，我们建议，任何AIDS患者，若痰或支气管镜冲洗液中发现非结核分枝杆菌，即使胸部X线片显示无病变，在进行血、骨髓、粪便和尿培养评估时，应初步归类为播散性感染。
