中枢神经系统组织等离子体与肺结核在HIV阴性患者的同时存在:病例报告
Bhuvanesh Kumar1, Dipasha Agarwal1, Durga Shankar Meena2
1Infectious Diseases Fellow, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India.
BMC infectious diseases
|November 15, 2024
概括
结核病和组织等离子体病的同时感染在免疫能力强的个体中很少发生. 这一案例凸显了在治疗期间考虑两种疾病的重要性,因为症状重叠和潜在的药物相互作用.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 临床病例报告 临床病例报告
背景情况:
- 结核病 (TB) 在印度非常普遍; 血清是一种新兴的,经常被低估的真菌感染.
- 同时感染结核病和血清是罕见的,特别是在免疫能力强的宿主中.
- 症状重叠可能导致错过诊断和治疗延迟两个条件.
研究的目的:
- 报告一种罕见的同时发生结核病和组织等离子体病的病例,该病例发生在一个具有免疫能力的患者身上.
- 为了说明由共感染引起的诊断挑战和治疗复杂性.
- 强调对潜在药物相互作用的警至关重要.
主要方法:
- 一名62岁的男性出现了慢性发烧,咳,壮病,淋巴腺病变和全细胞减肥.
- 结核病的诊断是通过淋巴结活检的基于弹的核酸放大测试 (CBNAAT) 确认的.
- 骨髓活检显示出血清;开始使用伊特拉科纳和抗结核药物的双重治疗.
主要成果:
- 最初的治疗反应随后是脑损伤的发展和CSF基因质抗原的阳性.
- 治疗失败归因于药物相互作用,特别是因利芬素导致的低于最佳的伊特拉科纳水平.
- 静脉输液脂肪体安波特里辛B和修改的抗结核疗法导致显著的临床改善和中枢神经系统病变的解决.
结论:
- 结核病的诊断并不排除并发性组织等离子体,即使在非艾滋病毒患者中,由于症状重叠.
- 对于抗真菌和抗结核药物之间的潜在药物相互作用的警对于有效管理至关重要.
- 这一案例凸显了复杂的共感染中全面诊断和仔细的治疗监测的重要性.
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