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。
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.
出处
《首都医科大学学报》
CAS
2006年第2期194-197,共4页
Journal of Capital Medical University
关键词
艾滋病
真菌病
青霉菌
acquired immunodeficiency syndrome
mycoses
penicillium
