播散型组织胞浆菌病21例临床研究

目的：探讨播散型组织胞浆菌病（PDH）的临床特点、诊断及治疗。方法：回顾性分析21例PDH患者的临床资料。结果：PDH的临床表现主要有发热,肝、脾肿大,各类血细胞减少等。18例经骨髓涂片确诊,3例经病理活检确诊。给予抗真菌药物治疗,19例治愈,2例放弃治疗后死亡。结论：通过骨髓涂片、病理组织切片进行病原学检查是确诊的依据。两性霉素B、伊曲康唑和氟康唑治疗有效。

Experiences of diagnosis and treatment of 21 cases with progressive disseminated histoplasmosis

Objective To explore the clinical features,diagnosis and therapeutic approach of progressive disseminated histoplasmosis(PDH).Method The clinical data of 21 cases of PDH diagnosed in our hospital in the past eight years were retrospectively analyzed.Results The main clinical manifestations were fever,hepatosplenomegaly and blood cell count decreasing,and so on.Among the 21 cases,18 cases were diagnosed by bone marrow smear and 3 cases were confirmed by pathological biopsy.After antifungal treatment,19 patients were cured and 2 patients died after withdrawal of treatment.Conclusion According to bone marrow smear and pathological biopsy,pathogentic examination are foundation for diagnosis.Amphotericin B,itraconazole and fluconazole are effective therapeutic drugs.