- 期刊
Esophageal Cytomegalovirus Infection in an Acquired Immune Deficiency Syndrome Patient
後天免疫不全症候群病人的食道巨細胞病毒感染
摘要
巨細胞病毒(CMV)感染常發生在嚴重免疫能力缺損的病人。後天免疫不全症候群、移植手術後接受免疫抑制治療或惡性腫瘤接受化學治療和長期使用類固醇的病人均為高危險因子。巨細胞病毒感染可能存在愛滋病人的胃腸道內，但祗有少數病人會發生臨床上明顯的症狀。AIDS病人感染巨細胞病毒最重要的診斷標準在於排除其它的感染病原如黴菌、其它病毒、寄生蟲和細菌感染，並在被感染細胞中可見病毒的包涵體(inclusion body)。我們在此報導一位未接受規則抗愛滋病病毒藥物治療40歲愛滋病人，他因漸進性的嘔吐、心灼熱感和胸痛超過一個月，接受上消化道內視鏡檢查，發現食道有二個深的漬瘍，從漬瘍底部取切片檢體並以Hematoxylin eosion stain染色和針對巨細胞病毒單株抗體(anti-CMV monoclonal Antibody)特別免疫組織化學染色証實CMV感染。經ganciclovir治療3星期後，臨床症狀消失並開始抗HIV的治療，現在病況穩定，仍一直在門診追蹤。
並列摘要
Cytomegalovirus (CMV) infections can occur in severe immunocompromised populations. Those patients suffered from the acquired immunodeficiency syndrome (AIDS), received immunosuppressive therapy after transplantation or chemotherapy for malignant disease and long-term steroid users are at high risk. CMV can be present in the gastrointestinal tract of the AIDS patients but only a few of them develop clinically apparent CMV diseases. The gold standard of diagnosis for CMV infection in AIDS patients is the presence of viral inclusion bodies in infected cells after the exclusion of other infections like fungus, other virus, parasite, and bacteria. Herein we report a 40-year-old man with AIDS who had poor compliance to anti-HIV medication. He suffered from progressive vomiting, heartburn sensation and chest pain for more than one month. Two pouched-out ulcers were observed by endoscopic examination. CMV inclusion body was confirmed by forceps biopsies from the ulcer bases with hematoxylin eosin stain and special immunohistochemical stain to anti-CMV monoclonal antibody. After 3 weeks course of ganciclovir treatment, he was symptom-free with maintaining anti-HIV medication therapy.