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Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection
作者姓名:LU Pu-xuan  ZHU Wen-ke  ZHAN Neng-yong  LIU Yan  CHEN Xin-chun  YE Ru-xin  CAI Li-sheng  ZHU Bo-ping
作者单位:[1]Department of Radiology, Shenzhen East Lake Hospital, Shenzhen 518020, China [2]Department of Infectious Diseases, Shenzhen East Lake Hospital, Shenzhen 518020, China [3]Department of Laboratory Examination, Shenzhen East Lake Hospital, Shenzhen 518020, China [4]Department of Laboratory Examination, the Second Hospital of Shenzhen 518020, China
基金项目:the sustentation fund item of WU Jie-ping (2003-86-F).
摘    要:Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei (PM) infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results (1) The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture. All the 12 cases (100%) had irregular fever (38-41℃) and enlarged lymph nodes, 8 cases (66%) had skin rashes; 8 cases (66%) had hepatomegaly; 9 cases (75%) had splenomegaly while 8 cases (66%) had anemia. (2) Imaging manifestation: Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 cases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung, and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS (CD4 T lymphocytes 〈50/μ L) with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver, spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of "cakes".

关 键 词:艾滋病  免疫缺陷综合征  青霉素  治疗
收稿时间:2005-09-20
修稿时间:2005-11-21

Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection
LU Pu-xuan,ZHU Wen-ke,ZHAN Neng-yong,LIU Yan,CHEN Xin-chun,YE Ru-xin,CAI Li-sheng,ZHU Bo-ping.Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection[J].Chinese Journal of Interventional Imaging and Therapy,2006,3(1):63-68.
Authors:LU Pu-xuan  ZHU Wen-ke  ZHAN Neng-yong  LIU Yan  CHEN Xin-chun  YE Ru-xin  CAI Li-sheng and ZHU Bo-ping
Institution:1. Department of Radiology, Shenzhen East Lake Hospital, Shenzhen 518020, China
2. Department of Laboratory Examination, Shenzhen East Lake Hospital, Shenzhen 518020, China
3. Department of Infectious Diseases, Shenzhen East Lake Hospital, Shenzhen 518020, China
4. Department of Laboratory Examination, the Second Hospital of Shenzhen 518020, China
Abstract:Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei (PM) infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results (1) The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture. All the 12 cases (100%) had irregular fever (38-41 ) and enlarged lymph nodes, 8 cases (66%) had skin rashes; 8 cases (66%) had hepatomegaly; 9 cases (75%) had splenomegaly while 8 cases (66%) had anemia. (2) Imaging manifestation: Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 cases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung, and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS (CD4 T lymphocytes <50/ u L) with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver, spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of "cakes".
Keywords:Acquired immunodeficiency syndrome  Penicillium marneffei  Clinical characteristics  Imaging manifestations
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