摘要
目的探讨AIDS合并播散性马尔尼菲青霉菌病(disseminated penicilliosis mameffei,DPSM)的临床特征。方法回顾性分析2010年1月—2014年2月本院收治的36例确诊为A[DS合并DPSM患者的临床表现和实验室资料。结果患者以青壮年为主,发热35例(97.2%),咳嗽30例(83.3%),贫血32例(88.9%),消瘦21例(58.3%),皮疹17例(47.2%),腹痛16例(44.4%),淋巴结肿大14例(38.9%)。患者血培养马尔尼菲青霉菌均阳性,骨髓培养阳性9例(25.0%)。单用两性霉素B治疗2例,两性霉素B+伊曲康唑序贯治疗11例,伏立康唑+伊曲康唑序贯治疗1例,单用伊曲康唑治疗14例,单用氟康唑治疗8例。好转出院17例(47.2%),自动出院11例(30.6%),死亡8例(22.2%)。结论 AIDS合并DPSM临床表现复杂多样,病情进展快,早期诊断、及时有效治疗可长期缓解或治愈DPSM。
Objective To investigate the clinical characteristics of disseminated penicilliosis marneffei（DPSM） in AIDS patients.Methods Clinical manifestations and laboratory data of 36 patients with DPSM treated in our hospital from January 2010 to February 2014 were retrospectively analyzed.Results Young adults accounted for the majority.Fever occurred in 35 patients（97.2%）,cough in 30 patients（83.3%）,anemia in 32 patients（88.9%）,weight loss in 21 patients（58.3%）,rash in 17 patients（47.2%）,abdominal pain in 16 patients（44.4%）,and swollen lymph nodes in 14 patients（38.9%）.Blood culture of all the patients was positive for Penicillium marneffei,and bone marrow culture positive in 9 patients（25.0%）.Two patients received amphotericin B alone,11 patients received amphotericin B and then switched to itraconazole,1 patient received voriconazole and men switched to itraconazole,14 patients received itraconazole alone,and 8 patients received fluconazole alone.Seventeen patients（47.2%） were improved and discharged,11 patients（30.6%） were discharged without recovery,and 8 patients（22.2%） died.Conclusions The clinical manifestations of AIDS patients with DPSM are complex and this complication may develop rapidly.Early diagnosis and timely treatment can alleviate or cure DPSM effectively.
出处
《传染病信息》
2015年第6期369-371,共3页
Infectious Disease Information
基金
云南省大理州人民医院2011年科学研究基金
