This is a report on the clinical courses and pathological findings in two gay male patients with
acquired immunodeficiency syndrome (
AIDS) infected in Japan. Case 1. A 39 year-old Japanese homosexual male was diagnosed as
amebic dysentery complicated with
liver abscess on admission. He was placed on
Metronidazole with complete relief. Serological tests was positive for
AIDS. On second admission, he was found to have
pneumocystis carinii pneumonia (PCP) and cytomegalo-viral
uveitis. Administration of
Pentamidine was partially effective, however the
therapy with Azidothimidine was discontinued by bone marrow suppression. On his third admission, he suffered from
cryptococcal meningitis and
therapy-resistant fungusemia. Finally he died of recurrent
pneumonia regardless of appropriate
therapies. Autopsy proved extended cryptococcal
infection in the brain, meninx, lungs, liver and kidney, and cytomegalo-
infection in the lungs, liver and kidney. Furthermore, atypical mycobacteriosis was found in the lymph nodes. There was no active findings compatible with PCP. Case 2. A 44 year-old Japanese homosexual male was admitted with
oral candidiasis and diagnosed as
AIDS related complex. He suffered from
pneumonia with marked improvement on
sulfamethoxazole-
Trimethoprim. On his second admission, he developed
diarrhea and was found to be infected with Giardia lambia. In addition, cytomegalo-
viral infection damaged his eye sight. He died of
pneumonia and
meningitis shortly there after. Autopsy proved a cytomegalo-
viral infection in the lung and colon, old lesions possibly caused by PCP in the lungs, and suppurative
meningitis in the meninx. These experiences confirm that
AIDS patients can be exposed to several
opportunistic infections at the same time in the multiple organs. Furthermore, it is suggested that homosexual patients with
AIDS may have unique
opportunistic infections such as
amebic dysentery or Giardia lamblia unlike other
AIDS patients related to
hemophilia.