Jablonowski H, Szelényi H, Becker K, Lübke H J, Borchard F, Strohmeyer G, Hengels K J
Medizinische Klinik und Poliklinik, Heinrich Heine Universität Düsseldorf.
Z Gastroenterol. 1994 Aug;32(8):441-3.
We report the case of a 46-year old HIV-infected patient who suffered from severe recurrent diarrhoea for 18 months. In stool cultures cryptosporidiae were identified. The cryptosporidial enteritis was unresponsive to therapy. In the further course of cryptosporidial infection the patient developed HIV-associated cholangitis with increasing upper abdominal pain, progredient laboratory cholestasis and morphological changes indicating posthepatic cholestasis. Papillary stenosis with erosive papilitis caused by cryptosporidia was diagnosed. Sphincterotomy significantly improved the clinical status of the patient. Cholangitis with associated crytosporidial infection in a HIV-infected patient ist discussed and necessary diagnostic and differential therapeutic approaches are described.
我们报告了一例46岁的HIV感染患者，该患者遭受严重复发性腹泻18个月。粪便培养中鉴定出隐孢子虫。隐孢子虫性肠炎对治疗无反应。在隐孢子虫感染的进一步病程中，患者出现了HIV相关胆管炎，伴有上腹部疼痛加剧、进行性实验室胆汁淤积以及提示肝后性胆汁淤积的形态学改变。诊断为隐孢子虫引起的乳头狭窄伴糜烂性乳头炎。括约肌切开术显著改善了患者的临床状况。本文讨论了HIV感染患者中伴有隐孢子虫感染的胆管炎，并描述了必要的诊断和鉴别治疗方法。
