Disseminated Mycobacterium avium-intracellulare infection in homosexual men dying of acquired immunodeficiency.
Disseminated Mycobacterium avium-intracellulare infection in homosexual men dying of acquired immunodeficiency.
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死于获得性免疫缺陷的同性恋男性中传播了鸟胞内分枝杆菌感染。
DOI：
10.1001/jama.1982.03330220024029
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
B. Johnson
中科院分区：
文献类型：
--
作者：
P. Zakowski;S. Fligiel;O. Berlin;B. Johnson
自1981年5月以来，在洛杉矶加州大学洛杉矶分校健康科学中心死亡的五名同性恋男子，患有获得性免疫缺陷和肺孢子虫肺炎、卡波西肉瘤或隐孢子虫病，他们都有禽-胞内分枝杆菌复合体的分枝杆菌，这些分枝杆菌是从死亡前或死后检查的组织中培养出来的。每个人都有播散性分枝杆菌感染的组织学证据。在所有病例中，在肺、脾和淋巴结的巨噬细胞中观察到抗酸微生物，在2例病例中，在各种其他器官中观察到抗酸微生物。其他严重的感染总是在尸检中发现--巨细胞病毒、隐孢子虫病和肺孢子虫病。在我们研究所死于获得性免疫缺陷的同性恋男性中，播散性细胞内分枝杆菌感染是如此引人注目，我们认为应该在所有此类患者中大力寻找分枝杆菌。在特定的微生物学诊断之前，对某些免疫缺陷病例进行分枝杆菌感染的经验性治疗可能是合理的。
Five homosexual men dying at UCLA Center for the Health Sciences, Los Angeles, with acquired immunodeficiency and Pneumocystis pneumonia, Kaposi's sarcoma, or cryptosporidiosis since May 1981 have all had mycobacteria of the Mycobacterium avium-intracellulare complex cultured from tissues taken just before death or at postmortem examination. Each man had histological evidence of disseminated mycobacterial infection. Acid-fast organisms were seen in macrophages in the lung, spleen, and lymph nodes in all cases and in a variety of additional organs in two cases. Other severe infections were always found at postmortem examination--cytomegalovirus, cryptosporidiosis, and Pneumocystis. Disseminated M avium-intracellulare infection has been so striking in homosexual males dying with acquired immunodeficiency at our institution that we believe a vigorous search for mycobacteria should be made in all such patients. Empiric therapy for mycobacterial infection may be justified in selected cases of immunodeficiency before a specific microbiological diagnosis.