马尔尼菲青霉所致的骨与关节病的临床与病理研究

介绍一种病人最感痛苦而医生最易发现的马尔尼菲青霉病临床表现--溶骨性病变和关节肿痛,作者认为骨髓是易感马尔尼菲青霉的组织,应该注意骨和关节在本病中的表现作为诊断及鉴别诊断的依据,但通常骨髓感染引起弥漫性巨噬细胞反应性增生并吞噬大量病原体而不发生溶骨性病变。溶骨性病变的基础是局部化脓性反应,局部病原体数量往往不多,关键在于大量白细胞堆积而导致酶性溶解。该病的骨与关节的损害有自愈倾向,但反复发作难于根治,需要较长时间的积极抗真菌治疗。

A CLINICAL AND PATHOLOGIC STUDY ON THE OSTEOLYTIC LESIONS AND ARTHROPATHY CAUSED BY PENICILLIUM MARNEFFEI

This paper introduced a most painful and easily discovered clinical manifestation of penicillium marneffei disease-osteolytic lesions and arthropathy.The author believed that the bone-marrow is susceptible to P.marneffei infection.We should pay attention to the clinical menifesta-tions of the bone lesions and arthropathy of this disease for the purpose of diagnosis and differentia-tion.However,ordinary bone marrow infection causes diffuse macrophages proliferative reaction and engulfes a lot of pathogenic bodies,but with no osteolysis.The basic cause of the osteolytic le-sions is the local purulent reaction, which usually contains not many pathogens. It is the collectionof a large munber of leukocytes which causes the enzemolysis. The osteolytic lesions and arthropathies of P. marneffei tend to self-healing,but relapsing again and again and permanent control is not easy.It needs a long term active anti-fungi treatment.