摘要
目的:分析广西壮族自治区马尔尼菲青霉病(PSM)的发病情况、临床特征、诊治及预后。方法:回顾性分析93例PSM患者的临床资料。结果:93例患者中并发艾滋病(AIDS)84例,非AIDS 9例。主要临床表现为发热、皮损、消瘦、贫血、淋巴结增大、咳嗽等。并发AIDS患者全身中毒症状严重,皮损泛发,且有坏死。93例患者中CD4^+细胞下降84例,临床标本马尔尼菲青霉菌培养阳性率由高到低依次为:血液、组织或脓液、骨髓。使用氟康唑、伊曲康唑及两性霉素B单独或联合治疗,以两性霉素B联合伊曲康唑口服疗效最佳。结论:广西壮族自治区PSM好发于AIDS患者,临床表现不典型,两性霉素B治疗效果肯定;合并AIDS的PSM患者与非AIDS患者在临床表现、治疗和预后有所不同。
Objective： To analyze the incidence, clinical features, diagnosis, therapeutic regimens and prognosis of Penicilliosis marneffei（PSM） found in Guangxi province. Methods： The clinical data of 93 patients with PSM found in Guangxi Province were analyzed retrospectively. Results： Among the 93 cases, 84 cases were associated with AIDS. The most common clinical presentations were fever, skin lesion, weight loss, anemia, lymphadenectasis and cough. The patients complicated with AIDS presented severe systemic toxic symptoms and disseminated necrotic eruptions. A decreased count of CD4^＋ T cells were found in 84 cases. The positive rates of fungal culture for different clinical specimens were decreased as follows： blood, tissue or purulence, bone marrow. The patients were treated with flueonazole, itraconazole or amphotericin B（AMB）, either separately or in combination. The better effects were seen in those using AMB along with oral itraeonazole. Conclusions： Most PSM cases in Guangxi were found in AIDS patients, with atypical clinical presentations and good responses to AMB therapy. There were some differences between the patients complicated with AIDS and those non-AIDS in the clinical features, therapeutic regimens and prognosis .
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2009年第2期69-72,共4页
Journal of Clinical Dermatology
