Nagai H, Hebisawa A, Akagawa S, Kawabe Y, Shishido H, Kurashima A, Sato K, Mori M, Katayama T
Department of Pulmonary Diseases, Tokyo National Chest Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Mar;35(3):267-72.
Six men (mean age: 36.3 +/- 29 years) infected with the human immunodeficiency virus (HIV), four Japanese and two from Myammar, were admitted to our hospital for treatment of tuberculosis. In five, HIV positivity on serologic testing was first found when tuberculosis was diagnosed. The mean CD4 cell count was 37.3 +/- 29.6/microliters. Results of tuberculin skin tests were negative in 5 patients. One patient had pulmonary tuberculosis and 5 had miliary tuberculosis. Hilar and mediastinal lymphadenopathy was found on chest X-ray films in 4 patients and superficial lymphadenopathy was found in all patients. All patients had positive mycobacterial cultures of sputum and 2 patients had positive tests for acid-fast bacilli on smears of lymph-node aspirates. In one patient with tuberculosis meningitis, a culture of cerebrospinal fluid for acid-fast bacilli was positive. Epithelioid cell granulomas were found in samples of lung, liver, and bone marrow from 4 patients. Mycobacterium tuberculosis was isolated from all patients, and was not resistant to isoniazid, rifampicin, ethambutol, or streptomycin. Therefore all patients responded well to treatment of tuberculosis.
6名感染人类免疫缺陷病毒（HIV）的男性（平均年龄：36.3±29岁），其中4名日本人，2名缅甸人，因肺结核入住我院接受治疗。5例患者在诊断肺结核时首次通过血清学检测发现HIV阳性。平均CD4细胞计数为37.3±29.6/微升。5例患者结核菌素皮肤试验结果为阴性。1例患者患有肺结核，5例患者患有粟粒性肺结核。4例患者胸部X光片发现肺门和纵隔淋巴结肿大，所有患者均发现浅表淋巴结肿大。所有患者痰培养结核分枝杆菌均为阳性，2例患者淋巴结穿刺涂片抗酸杆菌检测呈阳性。1例结核性脑膜炎患者脑脊液抗酸杆菌培养呈阳性。4例患者的肺、肝和骨髓样本中发现上皮样细胞肉芽肿。所有患者均分离出结核分枝杆菌，且对异烟肼、利福平、乙胺丁醇或链霉素均不耐药。因此，所有患者对肺结核治疗反应良好。
