AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were en...AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were enrolled in the study.Complete ophthalmologic examinations,color fundus photography,SD-OCT and fundus autofluorescence(FAF)were performed for all patients at the first visit and each follow-up visit.Retinal necrosis in CMVR was analyzed on SD-OCT and classified into two types,the typical type and the atypical type.RESULTS:Forty-one eyes of active CMVR and 4 eyes of recurrent CMVR were classified into typical type,and 4 eyes with graying retinal lesion without hemorrhage or only punctate hemorrhage were classified into atypical type.In active stage of CMVR,the retina in typical type was significant thickened with hyperreflective lesion and fullthickness disruption of retinal architecture with enlarged vessel;while in atypical type,the retina was also destroyed in all layers but without thickening or slightly thinned.The choroid,vitreous and retinal vessels were not significantly involved.In healed stage,the retina was thin with destroyed layers in both types.In typical type,FAF showed mottled hypofluorescence mixed with punctuate hyperfluorescence.In atypical type,the retina showed some"cavity"in outer nuclear layer,and FAF showed mild hyperfluorescence.CONCLUSION:SD-OCT show different changes in the retina in typical type and atypical type of CMVR,which should be useful in assisting diagnosis and follow-up management of the disease.展开更多
BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or muc...BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or mucous lesions.Patients with visceral KS are asymptomatic and clinically silent.As the disease advances,patients may progress from a normal condition to exhibiting severe symptoms.CASE SUMMARY A 27-year-old man presented with a 2-mo history of fever,bearing-down pain,and rectal bleeding.His hepatitis B virus DNA level was 2.7×107 IU/mL.Abdominal computed tomography(CT)indicated liver cirrhosis.Before he was admitted to our hospital,he was diagnosed with HIV infection.His CD4 count was 24 cells/μL.Pelvic cavity CT suggested a thickened rectum wall accompanied by multiple enlarged lymph nodes.The patient was initially treated as having haemorrhoidal varices with bleeding,telbivudine for anti-hepatitis B virus treatment,and antibiotics for anti-infection.After half a month of treatment,the patient felt that his lower lumbus ache and bearing-down pain had not improved,and a colonoscopy was conducted.The result revealed a rectal mass that was histologically confirmed as KS with rectal spindle cells that were positive for cluster of differentiation 117(CD117),CD34,human herpes virus 8,and CD31.He was administered systemic chemotherapy with 36 mg/d liposomal doxorubicin six times.The patient experienced no sign of lower gastrointestinal bleeding again.CONCLUSION This case highlights the diagnosis of primary KS with lower gastrointestinal bleeding in HIV-positive patients,which means visceral KS could not be excluded.The gold standard relies on colonoscopy and biopsy findings.展开更多
The John Cunningham(JC)polyomavirus was first discovered in a patient with progressive multifocal leukoencephalopathy(PML)in 1971.The diagnosis for PML includes definite(etiological)diagnosis and presumptive(clinical)...The John Cunningham(JC)polyomavirus was first discovered in a patient with progressive multifocal leukoencephalopathy(PML)in 1971.The diagnosis for PML includes definite(etiological)diagnosis and presumptive(clinical)diagnosis.The etiological diagnosis consists of cerebrospinal fluid(CSF)-confirmed PML(evidence of JC polyomavirus in the CSF)and tissue-confirmed PML(evidence of JC polyomavirus in brain tissues).The clinical diagnosis of PML is defined as evidence of typical clinical and magnetic resonance imaging(MRI)findings.[1]JC polyomavirus has a non-enveloped,closed circular double-stranded DNA genome with a full length of 5120 kb.The virus genome is composed of an early coding region,a late coding region,and a non-coding control region(NCCR).The early coding region encodes five proteins:the large tumor(T)antigen,the small T antigen,and three other T antigen-splicing variants(T’135,T’136,and T’165).展开更多
基金Supported by the National Science and Technology Major Project of China during the 13th Five-year plan period(No.2018ZX10302104).
文摘AIM:To observe the findings of spectral domain optical coherence tomography(SD-OCT)scan in cytomegalovirus retinitis(CMVR).METHODS:Forty-six eyes of 33 patients with acquired immunodeficiency syndrome and CMVR were enrolled in the study.Complete ophthalmologic examinations,color fundus photography,SD-OCT and fundus autofluorescence(FAF)were performed for all patients at the first visit and each follow-up visit.Retinal necrosis in CMVR was analyzed on SD-OCT and classified into two types,the typical type and the atypical type.RESULTS:Forty-one eyes of active CMVR and 4 eyes of recurrent CMVR were classified into typical type,and 4 eyes with graying retinal lesion without hemorrhage or only punctate hemorrhage were classified into atypical type.In active stage of CMVR,the retina in typical type was significant thickened with hyperreflective lesion and fullthickness disruption of retinal architecture with enlarged vessel;while in atypical type,the retina was also destroyed in all layers but without thickening or slightly thinned.The choroid,vitreous and retinal vessels were not significantly involved.In healed stage,the retina was thin with destroyed layers in both types.In typical type,FAF showed mottled hypofluorescence mixed with punctuate hyperfluorescence.In atypical type,the retina showed some"cavity"in outer nuclear layer,and FAF showed mild hyperfluorescence.CONCLUSION:SD-OCT show different changes in the retina in typical type and atypical type of CMVR,which should be useful in assisting diagnosis and follow-up management of the disease.
基金Supported by Chinese National Special Research Program for Important Infectious Diseases,No.2017ZX10202102-002-002National Science and Technology Major Project,No.2018ZX10715-014-004
文摘BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or mucous lesions.Patients with visceral KS are asymptomatic and clinically silent.As the disease advances,patients may progress from a normal condition to exhibiting severe symptoms.CASE SUMMARY A 27-year-old man presented with a 2-mo history of fever,bearing-down pain,and rectal bleeding.His hepatitis B virus DNA level was 2.7×107 IU/mL.Abdominal computed tomography(CT)indicated liver cirrhosis.Before he was admitted to our hospital,he was diagnosed with HIV infection.His CD4 count was 24 cells/μL.Pelvic cavity CT suggested a thickened rectum wall accompanied by multiple enlarged lymph nodes.The patient was initially treated as having haemorrhoidal varices with bleeding,telbivudine for anti-hepatitis B virus treatment,and antibiotics for anti-infection.After half a month of treatment,the patient felt that his lower lumbus ache and bearing-down pain had not improved,and a colonoscopy was conducted.The result revealed a rectal mass that was histologically confirmed as KS with rectal spindle cells that were positive for cluster of differentiation 117(CD117),CD34,human herpes virus 8,and CD31.He was administered systemic chemotherapy with 36 mg/d liposomal doxorubicin six times.The patient experienced no sign of lower gastrointestinal bleeding again.CONCLUSION This case highlights the diagnosis of primary KS with lower gastrointestinal bleeding in HIV-positive patients,which means visceral KS could not be excluded.The gold standard relies on colonoscopy and biopsy findings.
基金Project supported by the National Science and Technology Major Project of China During the 13th Five-Year Plan Period(Nos.2017ZX 10202102 , 2018ZX10715014)。
基金This work was supported by a grant from the National Major Science and Technology Projects for Important Infectious Diseases in China(No.2017ZX10202102-002-002)。
文摘The John Cunningham(JC)polyomavirus was first discovered in a patient with progressive multifocal leukoencephalopathy(PML)in 1971.The diagnosis for PML includes definite(etiological)diagnosis and presumptive(clinical)diagnosis.The etiological diagnosis consists of cerebrospinal fluid(CSF)-confirmed PML(evidence of JC polyomavirus in the CSF)and tissue-confirmed PML(evidence of JC polyomavirus in brain tissues).The clinical diagnosis of PML is defined as evidence of typical clinical and magnetic resonance imaging(MRI)findings.[1]JC polyomavirus has a non-enveloped,closed circular double-stranded DNA genome with a full length of 5120 kb.The virus genome is composed of an early coding region,a late coding region,and a non-coding control region(NCCR).The early coding region encodes five proteins:the large tumor(T)antigen,the small T antigen,and three other T antigen-splicing variants(T’135,T’136,and T’165).
