53例艾滋病合并马尔尼菲蓝状菌感染者的临床特点

目的 探讨艾滋病合并马尔尼菲蓝状菌（Talaromyces marneffei,TM）感染者的临床特点。方法 回顾性分析2016年7月—2018年8月医院收治的53例确诊为艾滋病合并马尔尼菲蓝状菌感染住院患者的临床及实验室资料,总结其临床特点。结果 2016年7月—2018年8月共2 019例住院艾滋病患者,旱季（10月至次年4月）1 135例中合并TM感染16例,阳性率1.4％;雨季（5—9月）住院艾滋病患者884例,合并TM感染37例,阳性率4.18％;53例艾滋病合并马尔尼菲蓝状菌感染患者,临床表现多样,缺乏特异性,脐凹样皮疹对马尔尼菲蓝状菌感染有诊断意义。结论 TM是深圳地区艾滋病患者条件致病菌之一;艾滋病合并马尔尼菲蓝状菌病（PSM）临床表现多样,无特异性,住院率有明显季节性,在雨季对于CD4⁺T淋巴细胞计数<10个/μL且合并贫血、血小板数量减少的艾滋病患者要重点考虑马尔尼菲蓝状菌感染可能。

Clinical analysis of 53 AIDS cases infected with Talaromyces marneffei

Objective To explore the clinical features of AIDS cases infected with Talaromyces marneffei. Methods The clinical data and laboratory data of 53 patients infected with Talaromyces marneffei and hospitalized between July 2016 to August 2018 were analyzed retrospectively, and their clinical characteristics were summarized. Results There were 2 019 cases of hospitalized patients with HIV/AIDS from July 2016 to August 2018. In the dry season (October to April in the following year), there were 1 135 cases of patients with HIV infections and 16(1.4%) cases complicated with Talaromyces marneffei; in the rainy season (May to September) there were 884 cases and 37(4.18%) cases complicated with Talaromyces marneffei infections. The clinical manifestations of 53 AIDS patients complicated with Talaromyces marneffei were various, and lacked of specificity. Umbilical concave sample rash had diagnostic significance. Conclusion Talaromyces marneffei is one of the opportunistic pathogens causing HIV infections in Shenzhen area. AIDS patients complicated with Talaromyces marneffei has no typical clinical features, but hospitalization rates is significantly characterized by season. The HIV/AIDS patients, whose CD4⁺ T lymphocyte count <10/μL with anemia, low level of platelet should be considered the possibility of Talaromyces marneffei infection, especially in the rainy season.