Fee M J, Oo M M, Gabayan A E, Radin D R, Barnes P F
Department of Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA.
Clin Infect Dis. 1995 Apr;20(4):938-44. doi: 10.1093/clinids/20.4.938.
We compared the presentation of abdominal tuberculosis in 43 patients infected with the human immunodeficiency virus (HIV) and in 35 patients without HIV infection. Fever, weight loss, and extraabdominal lymphadenopathy were more common in HIV-infected patients, whereas ascites and jaundice were more frequent in patients without HIV infection. Intraabdominal lymphadenopathy and visceral lesions, visualized on computed tomography scans, were more common in HIV-infected patients, whereas ascites and omental thickening were more frequent in patients without HIV infection. Aspirates of abdominal lymph nodes were the only samples revealing acid-fast bacilli in eight HIV-infected patients, yielding a rapid diagnosis. Disseminated tuberculosis was present in 93% of the HIV-infected patients, compared with 31% of those without HIV infection; tuberculosis contributed to death in 23% of HIV-infected patients and in 31% of those without HIV infection. We conclude that abdominal tuberculosis in HIV-infected patients is almost invariably a manifestation of disseminated disease and results in significant mortality.
我们比较了43例感染人类免疫缺陷病毒（HIV）的患者和35例未感染HIV的患者腹部结核的表现。发热、体重减轻和腹部外淋巴结病在HIV感染患者中更为常见，而腹水和黄疸在未感染HIV的患者中更为频繁。计算机断层扫描显示的腹腔内淋巴结病和内脏病变在HIV感染患者中更为常见，而腹水和网膜增厚在未感染HIV的患者中更为频繁。腹部淋巴结穿刺液是8例HIV感染患者中唯一检测出抗酸杆菌的样本，从而实现了快速诊断。93%的HIV感染患者存在播散性结核，而未感染HIV的患者中这一比例为31%；结核导致23%的HIV感染患者和31%的未感染HIV的患者死亡。我们得出结论，HIV感染患者的腹部结核几乎总是播散性疾病的表现，并导致显著的死亡率。
