Barzilai A, Rubinovich B, Blank-Porat D, Rubinstein E, Keller N, Levi I
Infectious Disease Unit, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Scand J Infect Dis. 1998;30(2):143-6. doi: 10.1080/003655498750003528.
Mycobacterium simiae is rarely isolated in clinical settings of non-HIV-infected patients. Isolation of M. simiae from clinical specimens in clusters has been limited to some parts of the world that include Israel, Cuba and the southern USA, mainly Texas. Only 8 patients with HIV and disseminated M. simiae infection have been previously described in the English literature. Successful treatment of disseminated M. simiae infection has never been reported and 6 of the cases have died within 8 months of diagnosis. We reviewed retrospectively the medical records of HIV-infected patients who had positive blood or bone marrow cultures for M. simiae at the Sheba Medical Center, Tel-Hashomer, Israel, between January 1992 and December 1996. A case of disseminated M. simiae infection was defined as isolation of M. simiae in blood or bone marrow culture in an HIV-infected patient with a compatible, otherwise unexplained, systemic disease. Mycobacterium simiae was isolated in blood and/or bone marrow cultures from 3 HIV-infected patients during the last 5 y. We describe the first successful treatment in AIDS patients with disseminated M. simiae infection. The patients are alive and well 20 months after instituting a combination of 3 antimycobacterial agents, clarithromycin, ethambutol and ciprofloxacin and intensive antiretroviral therapy.
猿猴分枝杆菌在非HIV感染患者的临床环境中很少分离得到。从临床标本中以聚集形式分离出猿猴分枝杆菌的情况仅限于世界上的一些地区，包括以色列、古巴和美国南部，主要是得克萨斯州。此前英文文献中仅描述过8例HIV患者并发播散性猿猴分枝杆菌感染。播散性猿猴分枝杆菌感染的成功治疗从未有过报道，其中6例在诊断后8个月内死亡。我们回顾性分析了1992年1月至1996年12月期间在以色列特拉哈希莫尔的谢巴医疗中心，血培养或骨髓培养中猿猴分枝杆菌呈阳性的HIV感染患者的病历。播散性猿猴分枝杆菌感染病例定义为在HIV感染患者的血培养或骨髓培养中分离出猿猴分枝杆菌，且患者患有与之相符的、无法用其他原因解释的全身性疾病。在过去5年中，从3例HIV感染患者的血和/或骨髓培养中分离出了猿猴分枝杆菌。我们描述了首例成功治疗艾滋病患者播散性猿猴分枝杆菌感染的病例。在采用克拉霉素、乙胺丁醇和环丙沙星三种抗分枝杆菌药物联合强化抗逆转录病毒治疗20个月后，这些患者仍然存活且情况良好。
