Cerebral Mycobacterium avium infection in an HIV-infected patient following immune reconstitution and cessation of therapy for disseminated Mycobacterium avium complex infection

被引：29

作者：

Murray R. ^{[3
]}

Mallal S. ^{[2
]}

Heath C. ^{[1
]}

French M. ^{[2
]}

机构：

[1] Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA

[2] Department of Clinical Immunology, Royal Perth Hospital, Perth, WA

[3] Department of Microbiology, Royal Darwin Hospital, Casuarina, NT 0811

来源：

European Journal of Clinical Microbiology and Infectious Diseases | 2001年 / 20卷 / 3期

关键词：

Immunologic Response; Maintenance Therapy; Clarithromycin; Protective Immunity; Significant Rise;

D O I：

10.1007/PL00011252

中图分类号：

学科分类号：

摘要：

Reported here is a case of cerebral Mycobacterium avium complex infection that occurred in an HIV-infected patient, who had been treated for disseminated infection and had discontinued clarithromycin and ethambutol following a significant rise in his CD4+ T-cell count after starting highly active antiretroviral therapy. He responded well to excision of the lesion and reinstitution of multidrug therapy. Caution should be exercised when considering ceasing maintenance therapy for disseminated Mycobacterium avium complex infection in HIV-infected patients who demonstrate an apparently good immunologic response to highly active antiretroviral therapy, as this response may not necessarily restore protective immunity against all opportunistic pathogens.

引用

页码：199 / 201

页数：2

共 15 条

[1] Snider W.D., Simpson D.M., Neilsen S., Gold J.W., Metroka C.E., Posner J.B., Neurological complications of the acquired immune deficiency syndrome: Analysis of 50 patients, Annals of Neurology, 14, pp. 403-418, (1983)
[2] Anders K., Steinsapir K.D., Iverson D.J., Glasgow B.J., Layfield L.J., Brown W.J., Cancilla P.A., Verity M.A., Vinters H.V., Neuropathologic findings in the acquired immunodeficiency syndrome (AIDS), Clinical Neuropathology, 5, pp. 1-20, (1986)
[3] Hirano A., Neuropathology of AIDS: Montefiore experience, Rinsho Shinkeigaku, 29, pp. 1546-1549, (1989)
[4] Gray F., Geny C., Lionnet F., Dournon E., Fenelon G., Gherardi R., Poirier J., Neuropathologic study of 135 adult cases of acquired immunodeficiency syndrome, Annales de Pathologie, 11, pp. 236-247, (1991)
[5] Gray F., Gherardi R., Keohane C., Favolini M., Sobel A., Poirer J., Pathology of the central nervous system in 40 cases of acquired immune deficiency syndrome (AIDS), Neuropathology and Applied Neurobiology, 14, pp. 365-380, (1988)
[6] Gyure K.A., Prayson R.A., Estes M.L., Hall G.S., Symptomatic Mycobacterium avium complex infection of the central nervous system. A case report and review of the literature, Archives of Pathology and Laboratory Medicine, 119, pp. 836-839, (1995)
[7] Heifets L., Susceptibility testing of Mycobacterium avium complex isolates: Antimicrobial Agents and Chemotherapy, 40, pp. 1759-1767, (1996)
[8] Converse P.J., Jones S.L., Astemborski J., Vlahov D., Graham N.M.H., Comparison of a tuberculin interferon-γassay with the tuberculin skin test in high-risk adults: Effect of human immunodeficiency virus infection, Journal of Infectious Diseases, 176, pp. 144-150, (1997)
[9] 1999 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with the human immunodeficiency virus, Morbidity and Mortality Weekly Report, 48, RR-10, pp. 1-166, (1999)
[10] Currier J.S., Williams P.L., Koletar S., Cohn S.E., Murphy R.L., Heald A.E., Hafner R., Bassily E.L., Lederman H.M., Knirsh C., Benson C.A., Valdez H., Aberg J.A., McCutchan J.A., Discontinuation of Mycobacterium avium complex prophylaxis in patients with antiretroviral therapy-induced increases in CD4+ cell count. A randomised, double-blind, placebo-controlled trial, Annals of Internal Medicine, 133, pp. 493-503, (2000)

← 1 2 →