PRIMARY LOCALIZED CUTANEOUS HISTOPLASMOSIS IN A PATIENT WITH ACQUIRED IMMUNODEFICIENCY SYNDROME
PRIMARY LOCALIZED CUTANEOUS HISTOPLASMOSIS IN A PATIENT WITH ACQUIRED IMMUNODEFICIENCY SYNDROME
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获得性免疫缺陷综合征患者的原发性局限性皮肤组织胞浆菌病
DOI：
10.1111/j.1365-4362.1995.tb02954.x
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发表时间：
1995
影响因子：
3.6
通讯作者：
D. Kokai
中科院分区：
文献类型：
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作者：
Aleksandar Lj. KRUNIC;E. Calonje;Djordje Jeftovic;S. Berger;M. Milinković;Ž. Laušević;N. Martinović;D. Kokai
一名35岁的白色男子于1993年1月到贝尔格莱德皮肤科就诊，有4周的病史，颈部有一个逐渐增大、无痛、中央溃疡的结节。他还抱怨不适、疲劳和体重减轻，但否认其他症状。就诊时用药包括异烟肼、氨苯砜乙胺嘧啶、氟康唑和双脱氧肌苷（ddl）。患者无同性恋史，但有长期静脉注射药物滥用史。他于1988年1月被诊断为无症状mv感染（CDC-II）。Western blot检测HIV-1酶联免疫吸附试验（ELISA）阳性。1989年11月，经淋巴结活检确诊为颈淋巴结结核。他的胸片清晰，腹部超声检查显示轻度肝脾肿大，无腹膜后淋巴结肿大。他没有任何其他器官或系统受累的症状或体征。根据修订后的疾病控制中心（CDC）对艾滋病的病例定义（1987年），"患者符合艾滋病诊断标准（CDC IV C）。他对标准三联抗结核治疗（INH、利福平、乙胺丁醇）反应良好，9个月后仍预防性使用INH，每日300 mg。1990年3月，患者出现口腔念珠菌病，口服酮康唑后控制良好。1990年12月，他的CD 4计数为90/cm ↑ 3，他开始每天服用齐多夫定（AZT），每周服用氨苯砜-乙胺嘧啶预防卡氏肺孢子虫肺炎（POP）。他的病情一直稳定，直到1992年12月，当时他由于齐多夫定诱导的骨髓毒性而出现全血细胞减少症。患者改用双脱氧肌苷（ddl），200 mg，每日两次，并停用齐多夫定。他的口腔念珠菌病对酮康唑产生耐药性，但对每日50 mg氟康唑有反应。1993年1月，患者出现左肾内脓肿，经静脉注射庆大霉素和口服头孢氨苄治疗。血液
A 35-year-old white man presented to the Department of Dermatology in Belgrade in January 1993 with a 4-week history of a gradually enlarging, painless, centrally ulcerated nodule on the neck. He also complained of malaise, fatigue, and weight loss, but other symptoms were denied. Medications at the time of presentation included isoniazid, dapsone-pyrimethamine, fluconazole, and dideoxyinosine (ddl). The patient had no history of homosexuality, but did have a long history of intravenous drug abuse. He was diagnosed as having an asymptomatic mv infection in January 1988 (CDC-II). Positive enzyme-linked immunosorbent assay (ELISA) for HIV-1 was confirmed by Western blot. In November 1989, tuberculous cervical lymphadenitis, confirmed by lymph node biopsy, was diagnosed. His chest film was clear and an abdominal ultrasound examination revealed mild hepatosplenomegaly without retroperitoneal lymphadenopathy. He had no symptoms or signs of any other organ or system involvement. According to the revised Centers for Disease Control (CDC) case definition for AIDS (1987),' the patient fulfilled the criteria for the diagnosis of AIDS (CDC IV C). He responded well to standard triple antituberculosis treatment (INH, rifampin, ethambutol) and after 9 months remained on prophylactic INH, 300 mg daily. In March 1990, he developed oral candidosis that was well controlled by oral ketoconazole. In December 1990, his CD4 count was 90 per cm^ and he was started on zidovudine (AZT), daily, and dapsone-pyrimethamine weekly as prophylaxis for Pneumocystis carinii penumonia (POP). His condition was stable until December 1992, when he developed pancytopenia due to zidovudine-induced myelotoxicity. He was switched to dideoxyinosine (ddl), 200 mg twice a day, and zidovudine was discontinued. His oral candidosis became resistant to ketoconazole, but responded to fluconazole, 50 mg daily. In January 1993, he developed a left intrarenal abscess that was treated with gentamicin iv and cephalexin, orally. Blood
获得性免疫缺陷综合征（艾滋病）中的组织胞浆菌病：用伊曲康唑和氟康唑治疗。
DOI：
--
发表时间：
1993
期刊：
Journal of acquired immune deficiency syndromes
影响因子：
--
作者：
Sharkey-Mathis,PK;Velez,J;Fetchick,R;Graybill,JR
通讯作者：
Graybill,JR