AIDS合并诺卡氏菌病、铜绿假单胞菌感染、巨细胞病毒脑炎1例并文献复习  

A case of AIDS complicated with nocardia disease,pseudomonas aeruginosa infection,cytomegalovirus encephalitis and literature review

作　　者：罗星星 谢小馨 符燕华 彭银霜 何金洪 何香溪 龙海 Luo Xingxing;Xie Xiaoxin;Fu Yanhua;Peng Yinshuang;He Jinhong;He Xiangxi;Long Hai(Guiyang Public Health Treatment Center Infection Department,Guizhou Guiyang 550004,China)

机构地区：[1]贵阳市公共卫生救治中心感染科,贵州贵阳550004

出　　处：《新发传染病电子杂志》2024年第5期73-77,共5页Electronic Journal of Emerging Infectious Diseases

摘　　要：本文报道1例艾滋病合并多重感染病例。患者为中年男性AIDS患者,因出现咳嗽、咳痰及发热等症状而前往当地医院就诊,经过HIV初筛及确诊阳性后转入贵阳市公共卫生救治中心。患者经相关检查,初步诊断为AIDS合并肺部感染,经抗菌等治疗后病情并未见好转。经多次痰培养、纤维支气管镜等检查,并送检肺泡灌洗液宏基因组二代测序(metagenomics next-generation sequencing,mNGS)检测,最终明确诊断为AIDS合并诺卡氏菌病(脓肿诺卡菌)、铜绿假单胞菌感染、巨细胞病毒脑炎。调整抗感染治疗方案和抗逆转录病毒治疗方案,患者病情好转并出院。该病例凸显了HIV对人体器官的侵害能力,是导致患者合并多重感染以及病情加重的重要原因。对于AIDS患者来说,合并其他感染的情况并不罕见,因此,准确的诊断和及时的治疗至关重要。通过本例患者治疗经历回顾,希望能够提高临床医生对AIDS患者合并多重感染的诊断、治疗水平,延长患者生命。This article reported a case of AIDS with multiple infection.The patient was a middle-aged man with AIDS who went to a local hospital for treatment due to symptoms such as cough,sputum and fever,and was transferred to Guiyang Public Health Treatment Center Infection Department after HIV preliminary screening and positive confirmation.After a series of examinations,the patient was initially diagnosed as AIDS combined with lung infection,and the condition did not improve significantly after antibacterial treatment.After multiple sputum culture,fiber bronchoscopeand other examinations,and sent to the alveolar lavage fluid for mNGS detection,the final diagnosis was clearly diagnosed as AIDS complicated with nocardia(nocardia abscess),pseudomonas aeruginosa infection,cytomegalovirus encephalitis.The antiinfective therapy regimen and antiretroviral therapy regimen were adjusted,and the patient improved and was discharged.This case highlights the ability of HIV to attack the human body and organs,which is an important reason for patients with multiple infections and worsening disease.It is not uncommon for people with AIDS to co-exist with other infections,so accurate diagnosis and timely treatment are essential.Through the review of the treatment experience of this case,we hope to strengthen the clinical doctors'ability to diagnose the co-infection of AIDS patients,improve the treatment effect and prolong the life of patients.

关 键 词：艾滋病 诺卡氏菌病 铜绿假单胞菌感染 巨细胞病毒脑炎 宏基因组二代测序检测 抗逆转录病毒治疗 

分 类 号：R515[医药卫生—内科学]