[HIV infection, fever and cholestasis].

S Giezendanner, G Zala, J Jost, P Greminger, C Meyenberger
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Abstract

A 35-year-old Swiss woman with AIDS experienced fever, jaundice and cough. Laboratory evaluation revealed signs of an infection and cholestasis. The examination by ultrasound showed thickening of the intra- and extrahepatic bile ducts and gallbladder wall, without dilatation or stones. Endoscopic retrograde cholangiography demonstrated diffuse sclerosing cholangitis like lesions in the biliary tract and confirmed the diagnosis of a HIV related cholangiopathy. The cause was a cytomegalovirus infection as shown by liver biopsy with detection of cytomegalovirus early antigen. The treatment with ganciclovir was of some efficacy with improvement of jaundice.

[HIV感染,发烧和胆汁淤积]。
一名35岁的瑞士妇女患有艾滋病,出现发烧、黄疸和咳嗽。实验室检查显示有感染和胆汁淤积的迹象。超声检查显示肝内、肝外胆管及胆囊壁增厚,无扩张及结石。内镜逆行胆道造影显示胆道弥漫性硬化性胆管炎样病变,确认HIV相关胆管病变的诊断。肝活检检测巨细胞病毒早期抗原显示为巨细胞病毒感染。更昔洛韦治疗黄疸有一定疗效。
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