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症例は血友病BでHIV陽性の17歳男性.臨床症状と胸部X線所見(空洞とcoin lesion)より肺結核を疑われたが,ツベルクリン反応と喀痰の抗酸菌培養はともに陰性であった.患者喀痰中よりDNAを抽出し,結核菌の19KDa遺伝子領域をpolymerase chain reaction法を用いて増幅,電気泳動したところ,標準結核菌株のDNAと同じ311 base pairsの位置に陽性バンドを認めた.患者の症状, X線所見は,抗結核剤による治療により改善した.本法は,結核の早期診断,とりわけ免疫不全に随伴する場合の診断に有用と思われる.

Diagnosis of mycobacterial infection by PCR method in a hemophiliac with HIV infection.