艾滋病合并马尔尼菲青霉病2例诊断分析

AIDS patient complicated by penicillium marneffei infection: two cases report

目的 提高艾滋病合并马尔尼菲青霉病的诊断率。方法 分析2例明确诊断为艾滋病合并马尔尼菲青霉病病例的 临床及病理资料并复习相关文献。结果 艾滋病合并马尔尼菲青霉病以“发热、淋巴结肿大、肺部阴影”为主要临床表现;淋 巴结病变主要为“淋巴细胞显著减少,淋巴结内组织细胞增生并见大量类圆形病原体,少数为腊肠状病原体,偶见横膈,胞质 嗜酸性,核弱碱性。结论 HIV主要破坏CD4阳性T细胞,导致机体免疫功能下降而感染马尔尼菲青霉菌;马尔尼菲青霉病 又成为艾滋病的表征之一。因此,有发热、咳嗽、淋巴结肿大、淋巴细胞数减少、双肺部阴影的患者要考虑艾滋病合并马尔尼 菲青霉病感染的可能。

Purpose To improve the diagnosis of acquired immunodeficiency syndrome(AIDS) and penicilliosis marneffei.Methods The clinical and pathological features of two AIDS patients complicated by penicilliosis marneffei were investigated and the literatures were reviewed.Results The main symptoms of AIDS and penicilliosis marneffei were fever,multiple lymphopathies and lymphopenia,and X-ray shadows on lungs in the HIV positive individual,and there were large number of yeast form of Penicillium marneffei inside the histiocytes,the fungi with special sausage type and cross septum.Conclusions HIV destroys the CD4 positive T lymphocytes and leads to immunodeficiency and predisposes to Penicillium marneffei in epidemic area.Thus,this mycosis may suggest the existenceof AIDS in HIV-infected patients. The clinical manifestations furnish evidence for the diagnosis of AIDS and penicilliosis marneffei.