Maiwald M, Meier-Willersen H J, Hartmann M, von Herbay A
Institute of Hygiene and Microbiology, University of Heidelberg, Germany.
J Clin Microbiol. 1995 May;33(5):1354-6. doi: 10.1128/jcm.33.5.1354-1356.1995.
A case of an AIDS patient infected with the Whipple's disease bacterium, Tropheryma whippelii, is reported. A DNA fragment with sequence specificity for the 16S rRNA gene of the bacterium was detected by PCR in a duodenal biopsy specimen from a 55-year-old male patient with AIDS and diarrhea. The biopsy specimen contained periodic acid-Schiff stain-positive macrophages which did not, however, resemble the sickleform-particle-containing cells characteristic of Whipple's disease. This observation raises two possibilities: either the patient had a coincidence of AIDS and Whipple's disease or Tropheryma whippelii acted as an opportunistic pathogen in this immunodeficient patient. The latter explanation is of interest in light of the ongoing discussion of immunologic abnormalities as predisposing factors for Whipple's disease.
报告了一例感染惠普尔病细菌——惠普尔嗜组织细胞菌的艾滋病患者。通过聚合酶链反应(PCR)在一名患有艾滋病和腹泻的55岁男性患者的十二指肠活检标本中检测到了一段对该细菌16S rRNA基因具有序列特异性的DNA片段。活检标本中含有过碘酸-希夫染色阳性巨噬细胞,但这些巨噬细胞与惠普尔病特征性的含镰状颗粒细胞并不相似。这一观察结果提出了两种可能性:要么该患者艾滋病与惠普尔病并存,要么惠普尔嗜组织细胞菌在这名免疫缺陷患者中作为一种机会性病原体起作用。鉴于目前正在讨论免疫异常作为惠普尔病的易感因素,后一种解释很有意思。