https://scholars.lib.ntu.edu.tw/handle/123456789/562614
標題: | The role of tissue studies in facilitating early initiation of antimycobacterial treatment in AIDS patients with disseminated mycobacterial disease | 作者: | SZU-MIN HSIEH CHIEN-CHING HUNG Chen M.-Y. PO-REN HSUEH SHAN-CHWEN CHANG KWEN-TAY LUH |
公開日期: | 1999 | 卷: | 3 | 期: | 6 | 起(迄)頁: | 521-527 | 來源出版物: | International Journal of Tuberculosis and Lung Disease | 摘要: | SETTING: The question of whether aggressive investigations are useful in diagnosis and initiation of treatment in AIDS patients with disseminated mycobacterial disease (DMD) is still under debate. OBJECTIVE: To define the role of tissue studies in facilitating early initiation of antimycobacterial treatment and in establishing diagnosis in AIDS patients with DMD. DESIGN: From July 1994 through June 1997, 167 AIDS cases with fever were evaluated by stepwise investigation using a standardized protocol. Data of DMD cases were analyzed to define the role of tissue studies. RESULTS: A total of 40 cases of culture-proven DMD were identified. Antimycobacterial treatment was initiated due to positive acid-fast bacilli smears of sputum in only five cases. In the remaining cases, positive pathologic findings from tissue biopsies (lymph node, bone marrow or liver) facilitated early initiation of treatment in 60% (21/35). In 50% of all cases (20/40), the diagnosis could not have been established if cultures of tissue biopsies had not been performed. Both the pathologic examinations and mycobacterial cultures from liver biopsies had positivity rates of more than 50% (53.8% and 69.2%, respectively). CONCLUSIONS: Tissue studies were useful in facilitating early initiation of treatment and establishing diagnosis at least in half of the AIDS cases with DMD. Liver biopsy is worthwhile if the cause of fever is not discovered using less invasive investigations. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/562614 | ISSN: | 1027-3719 | SDG/關鍵字: | cd4 antigen; tuberculostatic agent; acid fast bacterium; acquired immune deficiency syndrome; article; bacterium culture; biopsy; blood culture; bone marrow; bone marrow biopsy; human; human immunodeficiency virus infection; liver; liver biopsy; lymph node; lymph node biopsy; major clinical study; mycobacteriosis; priority journal; sputum culture; sputum smear; thorax radiography; Adult; AIDS-Related Opportunistic Infections; Antitubercular Agents; Biopsy, Needle; Bone Marrow; Female; Humans; Liver; Lymph Nodes; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Prognosis; Sensitivity and Specificity; Sputum; Statistics, Nonparametric; Treatment Outcome; Tuberculosis |
顯示於: | 醫學院附設醫院 (臺大醫院) |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。