DISSEMINATED HISTOPLASMOSIS IN PATIENTS WITH AIDS

被引:64
作者
NIGHTINGALE, SD
PARKS, JM
POUNDERS, SM
BURNS, DK
REYNOLDS, J
HERNANDEZ, JA
机构
[1] UNIV TEXAS,SW MED SCH,DEPT PATHOL,DALLAS,TX 75235
[2] UNIV TEXAS,SW MED SCH,DEPT RADIOL,DALLAS,TX 75235
[3] PARKLAND MEM HOSP & AFFILIATED INST,DALLAS,TX 75235
关键词
D O I
10.1097/00007611-199006000-00007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Disseminated histoplasmosis was diagnosed in 36 (4%) of 980 patients with AIDS seen at Parkland Memorial Hospital in Dallas, Texas before September 30, 1989. Diagnostic sensitivity of blood culture plus examination of peripheral smear was 88%; sensitivity of bone marrow aspiration and blood culture was 80%. Median CD4 lymphocyte count at diagnosis was 33/cu mm. Median actuarial survival from the date histoplasmosis was diagnosed was 188 days. Thirteen (36%) of the 36 patients died before adequate antifungal therapy could be administered, while 13 survived long enough to receive 1,500 mg of amphotericin B; actuarial survival of the latter group from the date 1,500 mg of amphotericin B had been infused was 47% at 1 year. The substantial early mortality of AIDS-associated disseminated histoplasmosis and the modestly encouraging survival of those who were diagnosed in time to receive adequate therapy raise the issues of surveillance, prophylaxis, and empiric therapy for this infection in selected HIV-positive patients. © 1990 Southern Medical Association.
引用
收藏
页码:624 / 630
页数:7
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