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8例艾滋病患者的分枝杆菌肺部感染:临床及影像学特征

[Mycobacterial lung infection in 8 patients with AIDS: clinical and radiological features].

作者信息

Kawana A, Toyota E, Kobayashi N, Kudo K, Genka I, Aoki M, Kusumoto K, Oka S

机构信息

Division of Pulmonology, International Medical Center of Japan.

出版信息

Kansenshogaku Zasshi. 1998 Mar;72(3):238-44. doi: 10.11150/kansenshogakuzasshi1970.72.238.

Abstract

The prevalence of mycobacterial infection in AIDS patients has increased in Japan. This report describes details of the clinical and radiological features of eight AIDS patients with mycobacterial disease (6 with M. tuberculosis infection and 2 with M. kansasii infection) in our hospital during the period from October 1995 through February 1997. Six of the 8 were men, and two were women. The mean age was 36.5 years. Six were Japanese, one was from Myanmar, and one was Malaysian. The median CD4 positive T lymphocyte counts (CD4 count) at the time of diagnosis of the M. tuberculosis was 75.5 (range 14-569/microliter, and the M. kansasii was 21.5 (range 19-24)/microliter. Clinical findings and symptoms of all patients were non-specific, but almost all patients had a cough and fever. In the radiographic findings, the patients of the M. tuberculosis group presented multiple hilar and mediastinal lymphadenopathy, miliary shadow, and obstructive pneumonia. Both M. kansasii patients showed a multiple infiltration shadow. There were no drug resistant strains in M. tuberculosis except on isolate with moderate resistant. to Streptomycin. These observations suggest that AIDS-associated mycobacterial disease shows atypical clinical and radiological features in some cases, especially in advanced stages of AIDS. Therefore, we need to recognize the characteristics of the clinical and radiological features of the patients with mycobacterial diseases and AIDS.

摘要

在日本,艾滋病患者中分枝杆菌感染的患病率有所上升。本报告描述了1995年10月至1997年2月期间我院8例患有分枝杆菌病的艾滋病患者(6例结核分枝杆菌感染,2例堪萨斯分枝杆菌感染)的临床和放射学特征细节。8例患者中6例为男性,2例为女性。平均年龄为36.5岁。6例为日本人,1例来自缅甸,1例来自马来西亚。诊断结核分枝杆菌时CD4阳性T淋巴细胞计数(CD4计数)的中位数为75.5(范围14 - 569/微升),堪萨斯分枝杆菌感染患者的CD4计数中位数为21.5(范围19 - 24)/微升。所有患者的临床症状和体征均无特异性,但几乎所有患者都有咳嗽和发热症状。在放射学表现方面,结核分枝杆菌感染组患者表现为多发肺门和纵隔淋巴结肿大、粟粒样阴影及阻塞性肺炎。2例堪萨斯分枝杆菌感染患者均表现为多发浸润阴影。结核分枝杆菌中除1株对链霉素中度耐药外,无耐药菌株。这些观察结果表明,艾滋病相关分枝杆菌病在某些情况下,尤其是在艾滋病晚期,表现出非典型的临床和放射学特征。因此,我们需要认识到分枝杆菌病合并艾滋病患者的临床和放射学特征。

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