Hui A N, Koss M N, Meyer P R
Hum Pathol. 1984 Jul;15(7):670-6. doi: 10.1016/s0046-8177(84)80293-2.
Necropsies were performed in 12 patients who fulfilled the Centers for Disease Control (CDC) criteria for acquired immunodeficiency syndrome (AIDS), and the postmortem findings were compared with the premortem diagnoses. All of the patients were men with a male sexual preference and histories of multiple episodes of venereal diseases. Four patients were intravenous drug abusers, while two abused amyl nitrate. All 12 of the patients had evidence of cellular immune deficiency at presentation. The causes of death were a variety of opportunistic infections and neoplasms. Pneumocystis carinii pneumonia was diagnosed prior to death in seven patients. Despite current therapy, all seven of those patients had persistent Pneumocystis carinii pneumonia at necropsy, as well as clinically undiagnosed cytomegalovirus infection. In addition, two cases of acid-fast infections, two of visceral candidiasis, one of pneumocystis pneumonia, one of central nervous system lymphoma, one of gram-negative bacterial pyelonephritis, and one of cutaneous aspergillosis were clinically unrecognized and untreated. Nine patients died with two or more infections. Thus, necropsy is a valuable tool for recognizing clinically undiagnosed infections and malignant disorders in AIDS.
对12例符合美国疾病控制中心（CDC）获得性免疫缺陷综合征（AIDS）标准的患者进行了尸检，并将尸检结果与生前诊断进行了比较。所有患者均为男性，有男性性取向且有多次性病发作史。4例患者为静脉吸毒者，2例滥用亚硝酸戊酯。所有12例患者就诊时均有细胞免疫缺陷的证据。死亡原因包括多种机会性感染和肿瘤。7例患者在死亡前被诊断为卡氏肺孢子虫肺炎。尽管进行了当前的治疗，但这7例患者在尸检时均有持续性卡氏肺孢子虫肺炎，以及临床上未被诊断出的巨细胞病毒感染。此外，2例抗酸菌感染、2例内脏念珠菌病、1例肺孢子虫肺炎、1例中枢神经系统淋巴瘤、1例革兰阴性细菌性肾盂肾炎和1例皮肤曲霉菌病在临床上未被识别和治疗。9例患者死于两种或更多种感染。因此，尸检是识别AIDS患者临床上未被诊断出的感染和恶性疾病的有价值工具。
