Khoo S H, Denning D W
Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, United Kingdom.
Clin Infect Dis. 1994 Aug;19 Suppl 1:S41-8. doi: 10.1093/clinids/19.supplement_1.s41.
The prolonged survival of profoundly immunocompromised patients with AIDS has contributed to the increasing recognition of aspergillus infections as an emerging problem. Nevertheless, many of these infections continue to be diagnosed only at autopsy. In this article we review details of 293 reported cases. Invasive aspergillosis occurs in advanced AIDS and most commonly affects the lungs, although brain involvement has also been frequently reported. The diagnosis is often difficult to make while the patient is alive, although examination of specimens obtained via bronchoalveolar lavage, percutaneous needle aspiration, or biopsy is often successful. Biopsy of the affected organ along with histologic examination and culture may be necessary for diagnosis. The dismal prognosis of invasive aspergillosis in patients with AIDS can be improved only with earlier diagnosis of disease and the availability of more-effective antifungal regimens.
艾滋病深度免疫功能低下患者的长期存活，使得曲霉感染作为一个新出现的问题越来越受到关注。然而，其中许多感染仍仅在尸检时才得以诊断。在本文中，我们回顾了293例报告病例的详细情况。侵袭性曲霉病发生于晚期艾滋病患者，最常累及肺部，不过脑部受累的情况也屡有报道。患者存活时诊断往往困难，尽管通过支气管肺泡灌洗、经皮针吸或活检获取标本进行检查常常能成功。为明确诊断，可能需要对受累器官进行活检并结合组织学检查和培养。只有更早地诊断疾病并提供更有效的抗真菌治疗方案，才能改善艾滋病患者侵袭性曲霉病的糟糕预后。
