【摘要】 目的探讨艾滋病合并马尔尼菲青霉菌感染患者的临床特征。方法回顾性分析2010年9月~2013年12月收治的10例艾滋病合并马尔尼菲青霉菌感染患者的临床及实验室资料。结果患者主要以发热、消瘦、贫血、咳嗽、乏力、纳差、腹泻、皮疹、淋巴结肿大等为临床特征;外周血CD4+T淋巴细胞为2个/μL者1例,(10~20)个/μL者4例,(20~30)个/μL者3例,60个/μL者1例,85个/μL者1例,血培养马尔尼菲青霉菌均阳性,其中合并口腔培养白假丝酵母菌阳性4例,痰培养白假丝酵母菌阳性2例,大便培养白假丝酵母菌阳性2例,痰涂片结核杆菌阳性1例,合并结核性淋巴炎1例;10例患者均以两性霉素B治疗,好转6例,自动出院2例,死亡2例。结论艾滋病合并马尔尼菲青霉菌感染临床表现缺乏特异性,可以表现为发热、消瘦、贫血、咳嗽、乏力、纳差、腹泻、皮疹、淋巴结肿大,多发生于外周血CD4+T淋巴细胞显著低下患者,两性霉素B治疗有效。更多还原

【Abstract】 Objective To explore the clinical and laboratory features of AIDS cases infected with Penicillium Marneffei.Methods Ten patients hospitalized between September 2010 to December 2013 were selected, the clinical and laboratoryfeatures of the 10 AIDS cases infected with disseminated Penicilliosis Marneffei were analyzed retrospectively. Results Themost presented clinical symptoms and signs in descending order were long-term fever, progressive symptosis, anaemia, cough,fatigue, anorexia, diarrhea, skin rash, lymphadenectasis, and so on. Most patients had very low CD4+count in periphery blood,one case was 2/μL, four cases were between 10~20/μL, three cases were between 20~30/μL, one case was 60/μL, one casewas 85/μL. All patients was found to be positive for Penicilliosis Marneffei in blood culture, and 4 were positive in oral cavityculture for Blastomyces albican, 2 were positive in sputum culture for Blastomyces albican, 2 were positive in stool culture forBlastomyces albican, 1 was in positive in suptum smear for Bacillus tuberculosis, 1 was along with tuberculous lymphadenitis.All patients were treated with Amphotericin B and 6 were improved, 2 were discharged due to their own cases and 2 died.Conclusion The manifestations of AIDS patients complicated with disseminated Penicillium Marneffei mainly manifestedwith long-term fever, progressive symptosis, anaemia, cough, fatigue, anorexia, diarrhea, skin rash, lymphadenectasis and so on,but lack of specificity; Penicillium Marneffei infection is mostly seen in AIDS patients with significantly lower CD4+count;Amphotericin B is effective for treatment of patients.更多还原