摘要
目的:通过分析83例艾滋病合并真菌感染的临床病例,提高对HIV/AIDS早期诊断能力,减少临床误诊。方法:收集HIV感染者83例,均经湖北省疾病控制中心HIV确认试验确诊。分析患者的临床症状、体征及实验室检查,重点观察真菌感染的种类及部位,并进行相应真菌培养及药敏试验。结果:主要全身症状有长期发热、慢性腹泻、咳嗽及进行性消瘦、恶液质等。实验室检查提示所有患者CD4+细胞计数均<200 cell/μL,最低者仅为8 cell/μL。83例中伴有消化道念珠菌感染4例,呼吸道念珠菌感染2例,另有隐球菌脑膜炎4例,卡氏肺孢子虫肺炎4例,肺组织胞浆菌病2例,马尔尼菲青霉菌感染2例。真菌培养及耐药性显示念珠菌对氟康唑类药物已产生一定耐药性。结论:HIV感染者伴口腔念珠菌病的发生表明其已进入AIDS病期,口腔念珠菌病的出现可作为早期发现AIDS的重要临床指症,常伴发于口腔念珠菌感染的其他部位的真菌感染亦为全身免疫功能下降的局部表现。
Objective：83 cases of AIDS with fungal infection were studied to improve the ability to diagnosis and reduce the clinical misdiagnosis.Method：83 cases of AIDS were collected.All of them were confirmed by center for disease control of Hubei Province.Symnptoms and physical examination,as well as laboratory data were analyzed.The types and places of fungal infections were the key observation.Fungal culture and susceptibility tests also were performed.Result：Systematic symptoms were manifested as fever,chronic diarrhea,cough and weight loss.CD4＋ count was below 200 cell/μL in all patients,the lowest even 8 cell/μL.In 83 cases,4 cases were digestive infection,2 cases were respiratory tract infection,4 cases were Cryptococcus neoformans meningitis,4 cases were pneumocystis carinii pneumonia,2 cases were lung histoplasmosis,2 case were Penicillium Marneffei.Fungal culture and resistance showed that candida has a certain resistance to fluconazole drugs.Conclusion：In HIV infected individuals,OC is indicated as AIDS stage,so the emerge of OC can be the key clinical symptom to detect AIDS early,other parts of the fungal infection with OC were also the results of immunodeficiency.
出处
《临床口腔医学杂志》
2014年第2期115-117,共3页
Journal of Clinical Stomatology
基金
湖北省自然科学基金(2004ABA168)
关键词
艾滋病
真菌
念珠菌
口腔
AIDS
Fungus
Candida albicans
Oral cavity
