Kishihara Y, Nakashima K, Nukina H, Hayashi J, Kashiwagi S
Department of General Medicine, Kyusyu University Hospital.
Kansenshogaku Zasshi. 1993 Dec;67(12):1223-7. doi: 10.11150/kansenshogakuzasshi1970.67.1223.
Two cases of Acquired Immune Deficiency Syndrome (AIDS) with disseminated non-tuberculous mycobacterial infection are reported. Both patients had hemophilia and were infected with Human Immunodeficiency Virus type 1 (HIV) by antihemophilic factor infusion. In case 1, a 44-year-old male, Mycobacterium marinum, which ordinarily causes cutaneous infection, was isolated from sputum before death and from the lung, spleen, bone marrow, liver and lymph node at autopsy. This is the first report of disseminated M. marinum infection with AIDS. In case 2, a 25-year-old male, Mycobacterium avium complex, which is the most common strain in non-tuberculous mycobacterial infection among patients with HIV, was isolated from the lung by TBLB and at autopsy from the lung, liver, spleen, bone marrow, lymph node, stomach, small intestine and testis. He also had a giant intraabdominal lymphadenopathy, associated with the M. avium complex infiltration. In conclusion, non-tuberculous mycobacteria can be easily disseminated in patients with AIDS because of dysfunction of cellular immunity, even when their primary lesions are not severe.
报告了两例获得性免疫缺陷综合征（艾滋病）合并播散性非结核分枝杆菌感染的病例。两名患者均患有血友病，通过输注抗血友病因子感染了1型人类免疫缺陷病毒（HIV）。病例1为一名44岁男性，在其生前痰液中分离出通常引起皮肤感染的海分枝杆菌，尸检时在肺、脾、骨髓、肝和淋巴结中也分离出该菌。这是艾滋病合并播散性海分枝杆菌感染的首例报告。病例2为一名25岁男性，通过经支气管肺活检在其肺中分离出鸟分枝杆菌复合群，该菌是HIV患者非结核分枝杆菌感染中最常见的菌株，尸检时在肺、肝、脾、骨髓、淋巴结、胃、小肠和睾丸中也分离出该菌。他还患有巨大的腹腔淋巴结病，与鸟分枝杆菌复合群浸润有关。总之，由于细胞免疫功能障碍，非结核分枝杆菌在艾滋病患者中很容易播散，即使其原发病变并不严重。
