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目的总结艾滋病(AIDS)合并马尔尼菲青霉菌病的临床特点及治疗转归情况。方法回顾性资料分析。结果 2006年2月-2011年2月,北京地坛医院感染中心确诊27例艾滋病合并马尔尼菲青霉菌病患者。临床表现以发热、咳嗽、盗汗、贫血、皮疹、腹痛、多部位淋巴结肿大为主;皮疹具有特征性,皮肤活检、血培养阳性率高;胸片或胸部CT主要表现为肺野斑片状或斑点状浸润阴影、弥漫粟粒样结节改变。患者的CD4+淋巴细胞计数均<100个/μL。3例痊愈出院,22例好转出院,2例死亡。结论马尔尼菲青霉菌病是我国南方常见的艾滋病机会性感染之一,但近年在北方就诊的患者中也并不少见。确诊需多次血培养及皮肤等部位的活检,该病易误诊为肺结核和淋巴结核,治疗上单独使用伊曲康唑也可达到满意疗效。
Objective To summarize the clinical features and treatment outcomes of AIDS combined with Penicillium marneffei. Methods Retrospective data analysis. Results From February 2006 to February 2011, 27 patients with AIDS and Penicillium marneffei were diagnosed in Beijing Ditan Hospital Infection Center. Clinical manifestations of fever, cough, night sweats, anemia, rash, abdominal pain, multiple parts of the main lymphadenopathy; rashes with features, skin biopsy, blood culture positive rate; chest X-ray or chest CT showed mainly lung field patchy Or spot-like infiltration of shadow, filled with miliary nodules change. Patients had CD4 + lymphocyte counts <100 / μL. Three patients were discharged, 22 patients were discharged and 2 patients died. Conclusion Penicillium marneffei is one of the common opportunistic infections of AIDS in southern China. However, it is not uncommon for penicillium marneffei to treat patients in the north in recent years. Confirmed the need for multiple blood cultures and skin biopsies, the disease is misdiagnosed as tuberculosis and lymph node tuberculosis, the treatment of itraconazole alone can achieve satisfactory results.