艾滋病合并弓形虫感染

ACQUIRED IMMUNODEFICIENCY SYNDROME COMPLICATING TOXOPLASMOSIS

目的 探讨弓形虫病并发于艾滋病时的临床病理学特征。方法 回顾性研究 17例艾滋病合并弓形虫病的常规尸检材料 ,总结其临床表现与病变特点。结果 17例患者均有神经系统受累的病理改变与相应临床症状 ,多数有呼吸系统症状但仅 4例查见弓形虫 ,8例心肌有弓形虫感染但无明显临床表现 ,8例为播散性感染 ,5例合并巨细胞病毒感染 ,10例血清弓形虫抗体效价升高 ,17例均在尸检组织中查到弓形虫 ,9例死于脑或肺弓形虫病。结论 弓形虫病与艾滋病有密切关系 ,并有一些重要的临床病理学特征 ,如潜在感染的复活 ,播散性感染 ,显著的脑部病变 ,合并其他机会性感染 ,血清抗体效价低下等。

Aim To explore the clinicopathological features of toxoplasmosis complicating acquired immunodeficiency syndrome(AIDS).Methods Seventeen autopsy cases of AIDS complicating toxoplasmosis were studied retrospectively to summarize the clinical appearance and pathological characteristics.Results Pathological changes of neuron system and corresponding clinical presentations were found in all 17 patients.Most patients showed the respiratory symptoms but toxoplasma were found in only 4 case.Toxoplasmic involement of myocardium were found in 8 patients without remarkable clinical appearance.Deseminated toxoplasmosis were seen in 8 cases.Five patients were coinfected with cytomegalovirus.Serum titer of toxoplasma raised in 10 cases.Toxoplasma were found in many kind of autopsied tissues of all patients and 9 patients died of cerebral or pulmonary toxoplasmosis.Conclusions Toxoplasmosis is closely associated with AIDS and have some important clinicopathological features such as reactivation of latent infection,disseminated infection,marked cerebral involvement,coinfection of other opportunistic pathogen,low serum titer,and so on.