Santosh V, Shankar S K, Das S, Pal L, Ravi V, Desai A, Sreedharan A, Khanna N, Chandramuki A, Satishchandra P
Department of Neuropathology, National Institute of Mental Health & Neuro Sciences, Bangalore.
Indian J Med Res. 1995 Apr;101:134-41.
Pathomorphological features of 10 HIV positive individuals studied at autopsy and biopsy are described. Nine patients had evidence of neuro-AIDS and eight of them succumbed to various opportunistic infections. One surviving patient underwent a diagnostic lymph node biopsy which revealed tuberculous lymphadenopathy. Cryptococcal meningitis was the commonest CNS opportunistic infection, seen in five cases, with disseminated systemic cryptococcosis in two. The other opportunistic infections included toxoplasma encephalitis in two, with acanthamoeba infection in one patient. Pulmonary tuberculosis was noted in three patients while other bacterial infections such as meningococcal meningitis, pseudomonas septicaemia were observed in three and pneumocystis carinii pneumonia in one. One seropositive individual was clinically asymptomatic but succumbed to a road traffic accident. The brain in this case showed features of HIV associated early leucoencephalopathy. Bacterial infections caused by organisms other than Mycobacterium tuberculosis associated with AIDS are often underdiagnosed and should be considered, especially in developing countries. In cases of cryptococcal and tuberculous meningitis or multiple parasitic infections, the patients should be screened for associated HIV infection.
描述了10例经尸检和活检研究的HIV阳性个体的病理形态学特征。9例患者有神经艾滋病的证据，其中8例死于各种机会性感染。1例存活患者接受了诊断性淋巴结活检，结果显示为结核性淋巴结病。隐球菌性脑膜炎是最常见的中枢神经系统机会性感染，有5例，其中2例伴有播散性系统性隐球菌病。其他机会性感染包括2例弓形虫脑炎，1例棘阿米巴感染。3例患者有肺结核，3例观察到其他细菌感染，如脑膜炎球菌性脑膜炎、假单胞菌败血症，1例有卡氏肺孢子虫肺炎。1例血清阳性个体临床上无症状，但死于交通事故。该病例的大脑显示出HIV相关早期白质脑病的特征。与艾滋病相关的非结核分枝杆菌以外的生物体引起的细菌感染常常诊断不足，应予以考虑，尤其是在发展中国家。对于隐球菌性和结核性脑膜炎或多种寄生虫感染的病例，应筛查相关的HIV感染。
