摘要
目的提高皮肌炎合并马尔尼菲青霉病的诊断率。方法分析1例皮肌炎合并马尔尼菲青霉病的临床病理资料、观察其病变的HE、PAS和六胺银染色,并复习相关文献。结果皮肌炎合并马尔尼菲青霉病以"发热、皮肤结节"为主要临床表现,皮肤病变主要为真皮血管周围和皮下脂肪中见组织细胞增生和类圆形病原体,脂肪组织灶状坏死及核碎裂,PAS和六胺银染色显示圆圈状病原体,中间有个小圆点,部分腊肠样细胞可见横隔。结论皮肌炎患者,有多年糖皮质激素使用的病史,出现发热和皮肤结节,抗生素治疗无效,应考虑马尔尼菲青霉病,通过真菌培养和病理活检确诊。
In order to improve the diagnostic efficiency for Penicillium marneffei infection,the clinicopathologic data of one case of dermatomyositis complicated with this infection were analyzed.The main clinical appearance of this patient consisted of fever and skin nodules.On histopathologic examination,there were a number of histiocyte hyperplasia and focal necrosis in the adipose layer and nuclear fragmentation.The yeast form of P.marneffei were found in the cytoplasm of marophages in adipose layer and around dermic vascellum as demonstrated by PAS and hexamethylene tetramine silver staining.Sometimes,the allanto-like cells with septum transversum could be detected.It is clear that the diagnosis of P.marneffei infection should be considered when patients with dermatomyositis manifested with fever and skin nodules,with history of steroid hormone usage and development of resistance to antibiotics.The final diagnosis depends upon the results of pathologic examination of skin biopsy and fungus cultivation.
出处
《中国人兽共患病学报》
CAS
CSCD
北大核心
2009年第11期1117-1120,共4页
Chinese Journal of Zoonoses
关键词
皮肌炎
马尔尼菲青霉病
病理学
临床
dermatomyositis penicilliosis marneffei pathology clinic
