艾滋病合并播散性马内菲青霉病1例

AIDS complicated with disseminated Penicillium marneffei infection : a case report

报告1例艾滋病合并播散性马内菲青霉病。患者女,31岁。因发热、咳嗽、乏力伴消瘦2个月入院。入院前半个月患者面部、躯干、上肢出现中央有凹陷或坏死的传染性软疣样皮损。入院后查人免疫缺陷病毒(HIV)抗体阳性。骨髓涂片、组织病理检查见细胞内外有大量酵母样细胞,部分中央有横隔(裂殖);骨髓、皮损及淋巴结真菌培养均阳性(25℃和37℃双相培养),经鉴定为马内菲青霉,25℃条件下培养为菌丝相,且有红色色素产生,37℃条件下培养为酵母相。诊断:艾滋病合并播散性马内菲青霉病。确诊后予以静脉滴注伊曲康唑,2周后发热消退、皮损缓解。

A 31-year-old woman had a two-month history of recurrent fever, generalized weakness, cough and weight loss. Fifteen days before hospitalization, papular skin lesions developed on her face, trunk, and arms, which were umbilicated or necrotic in the center. She was found to be positive for antibody to human immunodeficiency virus. Bone marrow smear and histopathology of biopsy specimen showed numerous intracellular and extracellular yeast-like organisms, some showed clear septation as they were undergoing division. Bone marrow aspirates, and biopsy of the skin or lymph nodes were cultured,the organism was identifies to be P. marneffei. She was diagnosed as AIDS complicated with disseminated P. marneffei infection, and was treated with intravenous itraconazole for two weeks, and the fever and skin lesions resolved.