Contini C, Romani R, Magno S, Delia S
Institute of Infectious and Respiratory Diseases, University of Ferrara, Italy.
Eur J Clin Microbiol Infect Dis. 1995 May;14(5):434-40. doi: 10.1007/BF02114900.
Toxoplasma gondii infection was investigated in 14 AIDS patients with neurological involvement who showed clinical and computer tomographic scan signs suggestive of toxoplasmic encephalitis or extraneuronal localization suggestive of toxoplasmic infection. Blood, lung secretion (bronchoalveolar lavage and/or induced sputum sample) and cerebral spinal fluid (CSF) samples were cultured, and the results compared with the results of direct examination by Giemsa and by immunofluorescence of lung secretions and CSF. Toxoplasma gondii were observed directly in only four patients by immunofluorescence in bronchoalveolar lavage, induced sputum and CSF samples, and in three of these patients by Giemsa staining of bronchoalveolar lavage and CSF smears. In contrast, parasites were detected after 48 h in blood cultures from 11 of the 14 AIDS patients, in CSF cultures from eight of them and also in cultures of bronchoalveolar lavage and induced sputum from the six patients with respiratory and radiological features indicative of lung tissue damage. The findings indicate the value of tissue culture for diagnosis of toxoplasmosis as well as for monitoring the effects of treatment and also indicate that culture of induced sputum could be a powerful tool in establishing the incidence of pulmonary toxoplasmosis in AIDS patients.
对14例有神经系统受累的艾滋病患者进行了弓形虫感染调查，这些患者表现出提示弓形虫脑炎的临床和计算机断层扫描体征，或提示弓形虫感染的神经外定位体征。对血液、肺分泌物（支气管肺泡灌洗和/或诱导痰样本）和脑脊液（CSF）样本进行培养，并将结果与通过吉姆萨染色和肺分泌物及脑脊液免疫荧光直接检查的结果进行比较。仅在4例患者的支气管肺泡灌洗、诱导痰和脑脊液样本中通过免疫荧光直接观察到弓形虫，其中3例患者的支气管肺泡灌洗和脑脊液涂片经吉姆萨染色也观察到了寄生虫。相比之下，在14例艾滋病患者中的11例血液培养48小时后检测到寄生虫，8例患者的脑脊液培养中检测到寄生虫，6例有提示肺组织损伤的呼吸和放射学特征的患者的支气管肺泡灌洗和诱导痰培养中也检测到寄生虫。这些发现表明组织培养在弓形虫病诊断以及监测治疗效果方面的价值，还表明诱导痰培养可能是确定艾滋病患者肺弓形虫病发病率方面的有力工具。
