AIDS 艾滋病

“AIDS-DEFININGOPPORTUNISTICINFECTIONSANDNEOPLASMS”Table5-11,page125Kumar,Cotran,RobbinsBasicPathologyPROTOZOALANDHELMINTHICINFECTIONS1.Cryptosporidiosisorisosporidiosis:enteritiswithdiarrhea2.Pneumocystosis(pneumoniaanddisseminated)3.Toxoplasmosis(pneumonia,CNS,heartinfection)CRYPTOSPORIDIOSISPneumocystiscariniipneumoniaPneumocystis:GMSstainToxoplasmosis:heartToxoacutemyocarditisToxocystinheartFUNGALINFECTIONS•Candidiasis(thrush/esophagus,trachea,lung•Cryptococcus(CNS,lung,gut,eye,skin)•Coccidioidomycosis(acutedisseminated)•Histoplasmosis(acutedisseminated)CandidaalbicansEVERYBODYWITHAIDSGETSCANDIDASTOMATITIS&PHARYNGITIS(THRUSH)ANDESOPHAGITISCandidaalbicansstomatitisCandidastomatitisCandidaesophagitisCryptococcosisDisseminatedacutecoccidioidomycosisDisseminatedacutehistoPASstainMycobacterialdiseasesDisseminatedorextrapulmonaryMycobacteriumavium-intracellulare(MAI)Mtb,pulmonaryorextrapulmonaryMAI-liverMAI:intestineMAI:intestine(acidfaststain)Nocardia:pneumonia,meningitis,disseminatedSalmonella&Shigella•PersistentdiarrheaiscommoninAIDS•CryptosporidiaandIsosporidiacommoncausesbutSalmonellaandShigellaenteritisalsooccur•SalmonellabacteremiawithoutanobvioussourceseenwithAIDS:organismmaybeoneofthelesscommonserotypes•Mycoticaneurysms,boneandjointinfection,lungs,pleura,pericardiumViralinfections•Cytomegalovirus(CMV)Pulmonary,intestinal,retinitis,CNS•Herpessimples(localized,disseminated)•Varicella-zoster,localizedordisseminated•Progressivemultifocalleukoencephalopathy(PML)CMVCMVCMVretinitisHERPESHERPESHerpesinclusions(pneumonia)Progressivemultifocalleukoencephalopathy(PML)•JCvirus(apapovavirus)•NorelationshiptoCreutzfeldt-Jacobdz.•Slowlyprogressive•Infectsoligodendroglia•Inclusions•DemyelinationPML:demyelinationPMLoligodendroglialinclusionPML:bizarreastrocytesNEOPLASMS•Kaposi’ssarcoma•Non-Hodgkin’slymphomas(Burkitt’s,immunoblastic)•Primarybrainlymphoma•InvasivecervicalcancerKaposi’ssarcomainAIDSKaposi’sofpalateHHV8andKaposi’s•Humanherpesvirus8(HHV-8)iswidelythoughttoc•auseKS.•Elevento20%ofpeoplewhotestnegativeforHIVpossessantibodiesagainstHHV-8.•AbouttwicethatpercentagewhotestpositiveforHIVhaveantibodiesagainstHHV-8.•FortypercentofthosewithbothHIVandHHV-8willgetKaposi's•HHV-8:presentinhighconcentrationinsalivaAIDSassoc.lymphomas–mostinbrainCNSlymphomainAIDSMostlyB-cell,manyEBVassociated