McGuinness G, Naidich D P, Garay S, Leitman B S, McCauley D I
Department of Radiology, New York University Medical Center/Bellevue Hospital, NY 10016.
J Comput Assist Tomogr. 1993 Mar-Apr;17(2):260-6. doi: 10.1097/00004728-199303000-00015.
The occurrence of bronchiectasis has only rarely been noted among the protean manifestations of HIV infection in the lungs. We retrospectively identified bronchiectasis on CT scans in 12 HIV + and/or AIDS patients in the absence of either documented mycobacterial infection or a history of prior recurrent pyogenic infection. Pneumonitis was documented in 10 of 12 cases. In eight cases, bronchiectasis was associated with episodes of pyogenic infection; four of these patients also had documented opportunistic infections, including three cases of Pneumocystis carinii pneumonia (PCP). Two patients had infection due solely to PCP. In two cases, bronchiectasis was found in association with one case each of lymphocytic interstitial pneumonitis and nonspecific interstitial pneumonitis, respectively. Although the true incidence of bronchiectasis in this population remains to be established, in our experience bronchiectasis should be considered among the varied pulmonary manifestations of HIV infection. Furthermore, the seemingly rapid development and extent of bronchiectasis in this population suggest an accelerated form of the disease.
在肺部HIV感染的多种表现中,支气管扩张的发生极为罕见。我们回顾性地在12例HIV阳性和/或艾滋病患者的CT扫描中发现了支气管扩张,这些患者既没有记录在案的分枝杆菌感染,也没有既往复发性化脓性感染病史。12例中有10例记录有肺炎。8例中,支气管扩张与化脓性感染发作有关;其中4例患者也有记录在案的机会性感染,包括3例卡氏肺孢子虫肺炎(PCP)。2例患者仅因PCP感染。2例中,支气管扩张分别与1例淋巴细胞间质性肺炎和非特异性间质性肺炎相关。尽管该人群中支气管扩张的真实发病率仍有待确定,但根据我们的经验,在HIV感染的各种肺部表现中应考虑到支气管扩张。此外,该人群中支气管扩张看似快速的发展和范围提示这是一种加速型疾病。