Koyama R, Nakanishi F, Katoh S
Hokkaido Prefecture Sapporo Kitano Hospital, Japan.
Kekkaku. 1994 Nov;69(11):693-8.
Recently we encountered a case of pulmonary tuberculosis with HIV infection. The patient was 54-years old male. His chief complaints were anemia, emaciation and severe diarrhea. He was admitted to our hospital on September 18, 1992. He had been diagnosed in another clinic as having pulmonary tuberculosis before the admission to our hospital. His chest films taken on admission revealed homogeneous infiltrates with cavitation in right upper lobe. Serial chest X-rays consisted with the findings of post-primary tuberculosis. Sputum smear for acid fast bacilli was positive. From his clinical manifestations and life-history, we had a suspicion that he had infected with HIV. Laboratory findings were as follows: serum albumin level was 1.9 g/dl, CRP was 10.2 mg/dl, serological tests for HIV were positive by EIA, IFA and western blott method, total lymphocyte count was 819/microliters, CD4+ T lymphocyte count was 120/microliter CD4+/CD8+ ratio was 0.2. He was treated with AZT, isoniazid, streptomycin and rifampicin. The disease progressed rapidly and interstitial pneumonia, jaundice and clouding of consciousness appeared at the terminal stage. He expired on October 14, 1992. In this paper, the authors reported a case of pulmonary tuberculosis with HIV infection and also reviewed 5 cases of pulmonary tuberculosis associated with HIV in Japan.
最近我们遇到一例合并人类免疫缺陷病毒（HIV）感染的肺结核患者。患者为一名54岁男性。其主要症状为贫血、消瘦和严重腹泻。他于1992年9月18日入院。在入住我院之前，他在另一家诊所被诊断为患有肺结核。入院时拍摄的胸部X线片显示右上叶有均匀性浸润伴空洞形成。系列胸部X线片结果符合原发性肺结核的表现。痰涂片抗酸杆菌检查呈阳性。根据其临床表现和生活史，我们怀疑他感染了HIV。实验室检查结果如下：血清白蛋白水平为1.9g/dl，C反应蛋白（CRP）为10.2mg/dl，HIV血清学检测通过酶免疫测定（EIA）、间接免疫荧光测定（IFA）和免疫印迹法均呈阳性，总淋巴细胞计数为819/微升，CD4+T淋巴细胞计数为120/微升，CD4+/CD8+比值为0.2。他接受了齐多夫定（AZT）、异烟肼、链霉素和利福平治疗。病情进展迅速，终末期出现间质性肺炎、黄疸和意识障碍。他于1992年10月14日死亡。在本文中，作者报告了一例合并HIV感染的肺结核病例，并回顾了日本5例与HIV相关的肺结核病例。
