Leyes M, Vara F, Reina J, Riera M, Siquier B, Villalonga C
Servicio de Medicina Interna, Hospital Son Dureta, Palma de Mallorca.
Enferm Infecc Microbiol Clin. 1994 Aug-Sep;12(7):332-6.
Campylobacter bacteria are frequent, and usually slight causes of diarrhea in a normal host while in an immunosuppressed host the diarrhea may lead to severe pictures. The aim of this study was to analyze the clinical features of gastroenteritis by Campylobacter spp. in hospitalized seronegative patients and in those with HIV infection.
A retrospective study of the cases of gastroenteritis by Campylobacter spp. in adult patients admitted in the authors' hospital from January 1988 to July 1993 was carried out.
Of the 20 patients studied with gastroenteritis by Campylobacter spp., 13 (65%) had HIV infection. The mean age of the patients was 38 years (range: 18-68 years) with 70% of the cases being males. Seventy seven percent of the HIV positive patients showed diagnostic criteria for AIDS while 71% of the seronegative patients showed a base disease and/or received steroid therapy. The length of the diarrhea was greater in the patients with HIV infection on comparison with the seronegative patients (25 vs. 6 days). The diarrhea persisted for more than 2 weeks in more than half of the cases of seropositive patients. Fever continued a mean of 24 days in the HIV positive patients as compared with only 5 days in the HIV negative cases. Most of the former patients were treated with erythromycin with good response. Gastroenteritis recurred in one patient and another patient with HIV infection presented a pseudoappendicular picture. No case of bacteremia was detected in either the seropositive or seronegative patients. Campylobacter jejuni was isolated in most of the cases with a high percentage of resistence to quinolone drugs. The mean CD4 lymphocyte count in HIV positive patients was 131/mm3 (range: 1-774). Mean survival following diagnosis of gastroenteritis by Campylobacter spp. was 8.9 months (range: 1-17) in the patients with AIDS.
Gastroenteritis by Campylobacter spp. in hospitalized patients was related with immunosuppressive states. A clinical profile of prolonged febrile diarrhea was common in HIV positive patients and was associated with a low number of CD4 lymphocytes, advanced HIV infection and short survival.
弯曲杆菌是常见的腹泻病因，在正常宿主中通常引起轻微腹泻，而在免疫抑制宿主中，腹泻可能导致严重后果。本研究旨在分析住院血清学阴性患者及HIV感染患者中弯曲杆菌属所致胃肠炎的临床特征。
对1988年1月至1993年7月作者所在医院收治的成年弯曲杆菌属所致胃肠炎病例进行回顾性研究。
在研究的20例弯曲杆菌属所致胃肠炎患者中，13例（65%）感染了HIV。患者的平均年龄为38岁（范围：18 - 68岁），70%为男性。77%的HIV阳性患者符合艾滋病诊断标准，而71%的血清学阴性患者有基础疾病和/或接受过类固醇治疗。与血清学阴性患者相比，HIV感染患者的腹泻持续时间更长（25天对6天）。超过一半的血清学阳性患者腹泻持续超过2周。HIV阳性患者发热平均持续24天，而HIV阴性患者仅持续5天。大多数前者患者接受红霉素治疗，反应良好。1例患者胃肠炎复发，另1例HIV感染患者表现为类似阑尾炎的症状。血清学阳性和血清学阴性患者均未检测到菌血症。大多数病例分离出空肠弯曲杆菌，对喹诺酮类药物耐药率较高。HIV阳性患者的平均CD4淋巴细胞计数为131/mm³（范围：1 - 774）。艾滋病患者弯曲杆菌属所致胃肠炎诊断后的平均生存期为8.9个月（范围：1 - 17个月）。
住院患者中弯曲杆菌属所致胃肠炎与免疫抑制状态有关。HIV阳性患者常见长期发热性腹泻的临床特征，且与CD4淋巴细胞数量低、HIV感染晚期及生存期短有关。
