儿童艾滋病合并马尔尼菲青霉病30例临床资料分析

目的：探讨儿童艾滋病（AIDS）合并马尔尼菲青霉病的临床特点及治疗转归，以提高对本病的认识。方法回顾性分析2007年6月至2012年6月，广州市第八人民医院收治的30例确诊为AIDS合并马尔尼菲青霉病的患儿的资料。结果儿童艾滋病（AIDS）合并马尔尼菲青霉菌感染病例近年来逐年增加，临床表现以发热、咳嗽、皮疹、淋巴结肿大、体质量下降为主，外周血CD4＋T淋巴细胞计数均＜50个/mm^3，特征型皮疹具有诊断意义，血培养、骨髓培养阳性率高；伊曲康唑口服液疗效较好。结论马尔尼菲青霉菌成为广州地区儿童艾滋病（AIDS）合并真菌感染的主要病原之一，马尔尼菲青霉病临床表现主要是发热、淋巴结肿大、特征性皮疹，基本发生于CD4＋淋巴细胞计数＜50个/mm^3的患儿，可通过血、骨髓培养及皮肤活检确诊，治疗使用伊曲康唑口服液安全、有效、可及性高。

Clinical Analysis of 30 Children AIDS Patients with Penicilliosis Marneffei Infection

Objective To investigate the clinical manifestations and prognosis of children AIDS patients with Penicilliosis Marneffei infection. Method Retrospectively analyzed the clinical data of 30 cases of AIDS children with Penicilliosis Marneffei infection. Result The number of AIDS children with Penicilliosis Marneffei infection increased year by year in recent years. The main clinical manifestations of Penicilliosis Marneffei infection in children AIDS patients were fever, cough, rash, enlarged lymph nodes, and body weight lost. The number of CD4＋T lymphocyte was lower than 50 cells/mm3. The characteristic rashes were of diagnostic signiifcance for Penicilliosis Marneffei infection. The positive rate of blood and bone marrow culture for Penicilliosis Marneffei was high. Itraconazole solution had rather good curative effect with Penicilliosis Marneffei infection in children AIDS patients. Conclusion Penicilliosis Marneffei has been one of the main microorganisms in children AIDS patients with fungal infection. The main clinical manifestations of Penicilliosis Marneffei infection in children AIDS patients are fever, cough, rash, enlarged lymph nodes, and body weight lost. Penicilliosis Marneffei infection in children AIDS patients mostly occur in the patient with CD4＋T lymphocyte number lower than 50 cells/mm3. Blood and bone marrow culture are very important in the diagnosis of Penicilliosis Marneffei infection. Itraconazole solution is effective, safe, and easy to obtain in the treat of Penicilliosis Marneffei infection.