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目的探讨艾滋病合并马尔尼菲青霉菌感染患者的临床特征。方法回顾性分析2010年9月~2013年12月收治的10例艾滋病合并马尔尼菲青霉菌感染患者的临床及实验室资料。结果患者主要以发热、消瘦、贫血、咳嗽、乏力、纳差、腹泻、皮疹、淋巴结肿大等为临床特征;外周血CD4+T淋巴细胞为2个/μL者1例,(10~20)个/μL者4例,(20~30)个/μL者3例,60个/μL者1例,85个/μL者1例,血培养马尔尼菲青霉菌均阳性,其中合并口腔培养白假丝酵母菌阳性4例,痰培养白假丝酵母菌阳性2例,大便培养白假丝酵母菌阳性2例,痰涂片结核杆菌阳性1例,合并结核性淋巴炎1例;10例患者均以两性霉素B治疗,好转6例,自动出院2例,死亡2例。结论艾滋病合并马尔尼菲青霉菌感染临床表现缺乏特异性,可以表现为发热、消瘦、贫血、咳嗽、乏力、纳差、腹泻、皮疹、淋巴结肿大,多发生于外周血CD4+T淋巴细胞显著低下患者,两性霉素B治疗有效。
Objective To investigate the clinical features of AIDS patients with penicillium marneffei infection. Methods The clinical and laboratory data of 10 AIDS patients with penicillium marneffei infection from September 2010 to December 2013 were analyzed retrospectively. Results The patients were mainly characterized by fever, weight loss, anemia, cough, fatigue, anorexia, diarrhea, skin rashes and swollen lymph nodes. The peripheral blood CD4 + T lymphocytes were 1 / A / μL in 4 cases, (20 ~ 30) / μL in 3 cases, 60 / μL in 1 case, 85 / μL in 1 case, blood culture Penicillium marneffei were positive, which combined with oral culture white Candida positive in 4 cases, sputum culture Candida albicans positive in 2 cases, Stool culture Candida albicans positive in 2 cases, sputum smear Mycobacterium tuberculosis positive in 1 case, with tuberculosis lymphadenopathy in 1 case; 10 patients Both amphotericin B treatment, improved in 6 cases, 2 cases were discharged automatically, 2 died. Conclusion The clinical manifestations of HIV infection with penicillium marneffei are not specific and may be manifested as fever, weight loss, anemia, cough, fatigue, anorexia, diarrhea, rash, lymph nodes, and peripheral blood CD4 + T lymphocytes Patients with low, amphotericin B treatment effective.