艾滋病合并马尔尼菲青霉病16例临床回顾分析

目的 分析该院确诊的艾滋病(AIDS)合并马尔尼菲青霉病(PSM)患者临床资料,提高对该病的认识.方法 回顾性分析16例AIDS合并PSM住院患者临床资料.结果 患者常见的临床表现包括:发热,咳嗽,咳痰,腹痛伴腹泻,肝脾肿大,腹水,淋巴结肿大,皮肤损害主要表现为颜面及躯干散在丘疹;CD4 +T淋巴细胞计数2~32 mm-3;13例患者中5例患者1,3-β-D葡聚糖检测(G实验)与半乳甘露聚糖抗原检测(GM实验)均为阳性,7例上述检查中有一项为阳性,1例上述检查均为阴性;16例患者均行抗真菌治疗,其中4例患者同时给予联合抗逆转录病毒(cART)治疗.2例患者因其它机会性感染死亡,其余14例好转出院.结论 PSM是AIDS常见的机会性感染,G实验与GM实验可能有助于PSM的早期诊断.

A retrospective analysis of the clinical characteristics of AIDS patients with penicilliosis marneffei

Objective To analyze the clinical characteristics of AIDS patients diagnosed with penicilliosis marneffeic(PSM)in our hos-pital to improve the recognition of the disease.Methods We performed a retrospective analysis of the medical records of 16 AIDS pa-tients diagnosed with PSM in Beijing You,an Hospital between January 2011 and May 2016.Results Common clinical manifestations included fever,cough,sputum,abdominal pain with diarrhea,liver splenomegaly,ascites,lymphadenopathy,skin lesions with rashes mainly distributed on the face and over the trunk,extremely low CD4 +T cell count(2-32 mm-3),and high viral load.Of all 16 cases studied,5 cases were positive for both G and GM tests and 7 cases were positive for either G or GM test.All 16 AIDS patients received antifungal therapy.However,only 4 patients also received combination antiretroviral therapy(cART)together with antifungal therapy. Fourteen patients were responsive to the treatments as their clinical symptoms were improved,and 2 patients died of opportunistic infec-tions with other pathogens.Conclusions PSM is one of the most common opportunistic infections in AIDS patients in China,and G and GM tests may be useful for PSM early diagnosis.