首都医科大学学报 ›› 2006, Vol. 27 ›› Issue (2): 194-197.

• 专题报道 • 上一篇    下一篇

4例艾滋病合并播散性马尔尼菲青霉菌病

梁连春, 章银娣, 吴昊   

  1. 首都医科大学附属北京佑安医院感染科
  • 收稿日期:2006-02-28 修回日期:1900-01-01 出版日期:2006-04-24 发布日期:2006-04-24

Clinical Analysis AIDS-associated Penicillium Marniffei in 4 Cases

Liang Lianchun, Zhang Yindi, Wu Hao   

  1. Department of Infections Diseases, Beijing You'an Hospital, Capital University of Medical Sciences
  • Received:2006-02-28 Revised:1900-01-01 Online:2006-04-24 Published:2006-04-24

摘要: 目的 探讨艾滋病(AIDS)合并播散性马尔尼菲青霉菌病(PSM)的临床及影像特征,提高对该病的认识.方法 分析北京佑安医院确诊的4例AIDS合并PSM患者的临床及影像资料.结果 4例患者临床主要表现为反复发热、咳嗽、淋巴结肿大、腹痛、腹泻、肝脾肿大、皮肤丘疹等.CD4明显减少.2例胸片表现为间质性或实质性改变;腹部CT表现为内脏、腹腔多发脓肿;1例胸部CT表现为肺部浸润、粟粒性结节伴纵隔、肺门淋巴结肿大.真菌培养:在37℃培养或组织中马尔尼菲青霉菌呈酵母相,组织细胞外真菌呈长而弯曲、有横隔的腊肠样.25℃培养,菌落呈暗红色绒毛状,可见红葡萄酒样色素扩散入培养基中.结论 AIDS合并PSM临床表现无特异性,遇到上述情况应考虑PSM,并行相关检查,对PSM的早期诊断、治疗和改善预后有重要意义.

关键词: 艾滋病, 真菌病, 青霉菌

Abstract: Objective To improve the understanding of AIDS-associated Penicilliosis marneffei(PSM).Methods Study the clinical data and imaging feature of four cases with PSM infection in patients with AIDS in Beijing You'an hospital.Results Four patients presented with prolonged fever,cough,lymphaden hypertrophy,abdominal pain,diarrhea,hepatomegaly,splenomegaly and popular skin lesion.CD4 cell count was reduced significantly.Two cases chest X-ray showed interstitial or alveolar pneumonia,Abdominal CT showed multiple abcess in peritoneal cavity and organs.Chest CT showed the patchy or consolidation,military nodules in the lung,lymphadenhy pertrophy in hilar and mediastasis.Fungus cultured:yeast-like cells were found in the culture at 37℃ or in tissues.The fungi outside the host cells were elongated,often curved,Sausage-like and with clear cemral septate.When cultured at 25℃,the produced a characteristic red Pigment,diffusing into the medium.Conclusion PSM infection in patients with AIDS has not specific clinical manifestation.Clinical doctors should consider the possibility of PSM when the patients have the above mentioned symptoms.Culture and pathological examination should be taken as soon as possible.It is important for the successful management and treatment of AIDS-associated PSM to make diagnosis rapidly and accurately.

Key words: acquired immunodeficiency syndrome, mycoses, penicillium

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